Healthcare Provider Details

I. General information

NPI: 1164735387
Provider Name (Legal Business Name): SARO SARKISIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2010
Last Update Date: 07/21/2021
Certification Date: 07/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1562 OPOSSUMTOWN PIKE
FREDERICK MD
21702-4920
US

IV. Provider business mailing address

PO BOX 37086
BALTIMORE MD
21297-3086
US

V. Phone/Fax

Practice location:
  • Phone: 301-662-8477
  • Fax:
Mailing address:
  • Phone: 240-439-8812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD449103
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberD0090258
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: