Healthcare Provider Details

I. General information

NPI: 1902980733
Provider Name (Legal Business Name): CYNTHIA DENISE SADLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CYNTHIA DENISE SADLER MD, MPH, JD

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 09/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 LAURIAN WAY NW
KENNESAW GA
30144-5165
US

IV. Provider business mailing address

1720 POWERS FERRY RD SE
MARIETTA GA
30067-5442
US

V. Phone/Fax

Practice location:
  • Phone: 202-425-3150
  • Fax:
Mailing address:
  • Phone: 202-425-3150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License NumberGA030874
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number030874
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number030874
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: