Provider Demographics
NPI:1104540210
Name:MARTINS, PAUL
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:MARTINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 TINKER RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-3799
Mailing Address - Country:US
Mailing Address - Phone:443-722-9039
Mailing Address - Fax:410-238-7236
Practice Address - Street 1:610 TINKER RD
Practice Address - Street 2:
Practice Address - City:MIDDLE RIVER
Practice Address - State:MD
Practice Address - Zip Code:21220-3799
Practice Address - Country:US
Practice Address - Phone:443-722-9039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR5204374U00000X, 163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No374U00000XNursing Service Related ProvidersHome Health Aide