Healthcare Provider Details

I. General information

NPI: 1568437036
Provider Name (Legal Business Name): MARGARET ELLEN SEARS-DEMENTHON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6578 GUILFORD RD
CLARKSVILLE MD
21029-1520
US

IV. Provider business mailing address

6578 GUILFORD RD
CLARKSVILLE MD
21029-1520
US

V. Phone/Fax

Practice location:
  • Phone: 301-854-1008
  • Fax: 301-854-0305
Mailing address:
  • Phone: 301-854-1008
  • Fax: 301-854-0305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberH0038052
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: