Healthcare Provider Details

I. General information

NPI: 1235100850
Provider Name (Legal Business Name): JOHN HOLLAND SADLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 10/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 HOLLINS ST
BALTIMORE MD
21201-1024
US

IV. Provider business mailing address

840 HOLLINS ST
BALTIMORE MD
21201-1024
US

V. Phone/Fax

Practice location:
  • Phone: 410-468-0900
  • Fax: 410-468-0911
Mailing address:
  • Phone: 410-468-0900
  • Fax: 410-468-0911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberD14336
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: