Healthcare Provider Details

I. General information

NPI: 1851486658
Provider Name (Legal Business Name): SABINE CONSTANZE DE LA CROIX-VAUBOIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 12/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4808 MOORLAND LN STE 109
BETHESDA MD
20814-6131
US

IV. Provider business mailing address

4808 MOORLAND LN STE 109
BETHESDA MD
20814-6131
US

V. Phone/Fax

Practice location:
  • Phone: 301-654-9476
  • Fax: 301-654-1164
Mailing address:
  • Phone: 301-654-9476
  • Fax: 301-654-1164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0069560
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: