MEDICARE: DR. MIMI POKUA MARTINS M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	D0088689	MD

General Provider Information

NPI Number	:	1366820847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIMI POKUA MARTINS M.D

Provider Business Mailing Address
First Line	:	3001 HOSPITAL DR
Second Line	:
City	:	CHEVERLY
State	:	MD
Zip	:	20785
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 OLNEY SANDY SPRING RD STE 140
Second Line	:
City	:	OLNEY
State	:	MD
Zip	:	20832-1494
Country	:	US
Telephone Number	:	301-570-6245
Fax Number	:	240-389-1888

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2015
Last Update Date	:	12/28/2021

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