MEDICARE: DR. MARTIN G PAUL MD

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	208600000X	Surgery Physician	MD15543	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	52-0595110	OTHER	MD	TAX ID

General Provider Information

NPI Number	:	1801871181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTIN G PAUL MD

Provider Business Mailing Address
First Line	:	6201 GREENLEIGH AVE
Second Line	:
City	:	MIDDLE RIVER
State	:	MD
Zip	:	21220-2004
Country	:	US
Telephone Number	:	410-933-6421
Fax Number	:

Provider Business Practice Location Address
First Line	:	5215 LOUGHBORO RD NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20016-2618
Country	:	US
Telephone Number	:	202-537-4000
Fax Number	:

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

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	08/16/2021

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