Healthcare Provider Details

I. General information

NPI: 1538317243
Provider Name (Legal Business Name): MARTIN W. GRAF M.D.,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2008
Last Update Date: 09/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15225 SHADY GROVE RD SUITE 203
ROCKVILLE MD
20850-3254
US

IV. Provider business mailing address

15225 SHADY GROVE RD 203
ROCKVILLE MD
20850-3254
US

V. Phone/Fax

Practice location:
  • Phone: 301-948-5092
  • Fax: 301-977-7811
Mailing address:
  • Phone: 301-948-5092
  • Fax: 301-977-7811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number07162
License Number StateMD

VIII. Authorized Official

Name: DR. MARTIN WILLIAM GRAF
Title or Position: PRESIDENT
Credential: M.D.
Phone: 301-948-5092