Martin, Stephanie Renee
Martin, Stephanie Renee is an individual health care provider with primary practice located at 2401 Brandermill Blvd Suite 250, Gambrills MD 21054-1690. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is her primary health care specialty. Martin, Stephanie Renee can be contacted via phone (410) 721-1507.Contact Information
Primary practice address
2401 Brandermill Blvd Suite 250
Gambrills MD 21054-1690
Phone: (410) 721-1507
Fax: (410) 721-1510
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 0116019263 | Virginia |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | C7-0004604 | Delaware |
| Allopathic & Osteopathic Physicians / Sports Medicine | 207RS0010X | D73127 | Maryland |
Profile Details
| NPI number | 1891992376 |
|---|---|
| LBN Legal business name | Martin, Stephanie Renee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2007 |
| Last updated | Apr 1st, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891992376 | NPPES |
| Maryland | MEDICAID | 053826400 | |
| Maryland | Other | K6440003 | |
| Maryland | Other | 97725101 | |
| Maryland | Other | 8527802 | |
| Maryland | Other | 9936846 |
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