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General NPI Number Information
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NPI Number | 1407112964
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Entity Type | Individual
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Provider Name | MARTHA FRANCES BRUCATO MD, PHD
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Gender | Female
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Dates
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Enumeration Date | 04/09/2012
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 5755 CEDAR LN
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City | COLUMBIA
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State | MD
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Zip | 21044-2912
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Country | US
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Telephone | 410-955-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 6201 GREENLEIGH AVE STE 140
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-2004
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | D0088679
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License Number State | MD
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