Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YS0123X | Facial Plastic Surgeon | 44713 | CO |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | D0075212 | MD |
NPI | 1720203474 |
---|---|
Provider Name | Dr. Rodrigo Martinez |
First Address | Greenbelt, MD 20770-2027 |
Second Address | Greenbelt, MD 20770-2027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 14/05/2013 |