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General NPI Number Information
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NPI Number | 1750608584
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Entity Type | Individual
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Provider Name | MARTIN BRUCE SATALOFF ATC
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Gender | Male
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Dates
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Enumeration Date | 05/04/2010
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Last Update Date | 09/10/2021
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Provider Practice Location Address
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Address Line | 8600 MCDONOGH RD MCDONOGH SCHOOL
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City | OWINGS MILLS
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State | MD
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Zip | 21117-1009
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Country | US
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Telephone | 410-581-4708
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Fax | 410-998-3528
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Provider Business Mailing Address
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Address Line | 8600 MCDONOGH RD
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City | OWINGS MILLS
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State | MD
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Zip | 21117-1009
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Country | US
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Telephone | 410-977-9369
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Fax | 410-998-3528
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | A0000070
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License Number State | MD
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