Healthcare Provider Details

I. General information

NPI: 1164639712
Provider Name (Legal Business Name): ZADA MASON SANDERS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 11/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3924 MINNESOTA AVE NE
WASHINGTON DC
20019-2661
US

IV. Provider business mailing address

6830 MIDDLEFIELD TERRACE
FORT WASHINGTON MD
20744
US

V. Phone/Fax

Practice location:
  • Phone: 202-806-7540
  • Fax: 202-806-7416
Mailing address:
  • Phone: 301-630-8825
  • Fax: 301-630-8825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD16957
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: