Provider Demographics
NPI:1538349527
Name:JASMIN, MARTINE FARAH (MD)
Entity type:Individual
Prefix:MISS
First Name:MARTINE
Middle Name:FARAH
Last Name:JASMIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8401 CONNECTICUT AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-5829
Mailing Address - Country:US
Mailing Address - Phone:301-907-3960
Mailing Address - Fax:
Practice Address - Street 1:8401 CONNECTICUT AVE STE 201
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-5829
Practice Address - Country:US
Practice Address - Phone:301-907-3960
Practice Address - Fax:301-652-4933
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD85945207R00000X
VA0101248786207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD556235001Medicaid