MEDICARE: DR. WILLIAM J SADLACK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	D0019207	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	9954	OTHER		CAREFIRST BCBS PROVIDER #

General Provider Information

NPI Number	:	1104819168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM J SADLACK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 791372
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21279-1372
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6420 ROCKLEDGE DR
Second Line	:	SUITE 2200
City	:	BETHESDA
State	:	MD
Zip	:	20817-7837
Country	:	US
Telephone Number	:	301-530-3220
Fax Number	:	301-530-4120

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	05/09/2013

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