Healthcare Provider Details

I. General information

NPI: 1417362187
Provider Name (Legal Business Name): SABRINA MARGARITA MCCLINTOCK D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2014
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 PERRY PKWY STE 5
GAITHERSBURG MD
20877-2145
US

IV. Provider business mailing address

11000 CANDLELIGHT LN
POTOMAC MD
20854-2758
US

V. Phone/Fax

Practice location:
  • Phone: 305-609-1513
  • Fax:
Mailing address:
  • Phone: 305-609-1513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberH0099376
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: