Healthcare Provider Details

I. General information

NPI: 1013029446
Provider Name (Legal Business Name): JOHN R SAUNDERS JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 12/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6569 N CHARLES ST SUITE 401
BALTIMORE MD
21204-6831
US

IV. Provider business mailing address

PO BOX 418953
BOSTON MA
02241-8953
US

V. Phone/Fax

Practice location:
  • Phone: 443-849-8940
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberD28133
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberD28133
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberD28133
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: