Healthcare Provider Details

I. General information

NPI: 1912816224
Provider Name (Legal Business Name): MARTHA DAMTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14437 BRADSHAW DR
SILVER SPRING MD
20905-6508
US

IV. Provider business mailing address

14437 BRADSHAW DR
SILVER SPRING MD
20905-6508
US

V. Phone/Fax

Practice location:
  • Phone: 682-564-7616
  • Fax:
Mailing address:
  • Phone: 682-564-7616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF01260004
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: