Healthcare Provider Details

I. General information

NPI: 1861870222
Provider Name (Legal Business Name): RHONDA MARTIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2015
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46440 BENEDICT DRIVE, SUITE 107
STERLING VA
20164-6602
US

IV. Provider business mailing address

224 D CORNWALL STREET NW STE 403
LEESBURG VA
20176-2704
US

V. Phone/Fax

Practice location:
  • Phone: 703-450-1125
  • Fax: 703-450-1145
Mailing address:
  • Phone: 703-737-6010
  • Fax: 703-443-8643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101056262
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: