Healthcare Provider Details

I. General information

NPI: 1124162730
Provider Name (Legal Business Name): AMIR SAKLA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW
WASHINGTON DC
20010-2976
US

IV. Provider business mailing address

1000 RIVER RD STE 100
CONSHOHOCKEN PA
19428-2439
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-9696
  • Fax:
Mailing address:
  • Phone: 800-355-3818
  • Fax: 610-834-2862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD20741
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0037159
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: