Provider Demographics
NPI:1861550204
Name:MARTIN, MARTHA BROWN (MD)
Entity type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:BROWN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:12106 WHIPPOORWILL LANE
Mailing Address - Street 2:
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4446
Mailing Address - Country:US
Mailing Address - Phone:301-881-4050
Mailing Address - Fax:301-881-4305
Practice Address - Street 1:12106 WHIPPOORWILL LANE
Practice Address - Street 2:
Practice Address - City:NORTH BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20852-4446
Practice Address - Country:US
Practice Address - Phone:301-881-4050
Practice Address - Fax:301-881-4305
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00294432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry