Healthcare Provider Details

I. General information

NPI: 1659411023
Provider Name (Legal Business Name): SHIRIN J SAHANDY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 02/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N WOLFE ST BLALOCK 1412
BALTIMORE MD
21287-0005
US

IV. Provider business mailing address

7222 BROOKFALLS TER
BALTIMORE MD
21209-1643
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-7609
  • Fax:
Mailing address:
  • Phone: 410-318-8869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberP20242
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: