Healthcare Provider Details

I. General information

NPI: 1376886713
Provider Name (Legal Business Name): SARA ROSENAU VIOLA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2013
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HOSPITAL DRIVE CCW (2W)
GLEN BURNIE MD
21061
US

IV. Provider business mailing address

300 HOSPITAL DR STE 121
GLEN BURNIE MD
21061-5706
US

V. Phone/Fax

Practice location:
  • Phone: 267-229-1019
  • Fax:
Mailing address:
  • Phone: 410-553-8240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD81126
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberD81126
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberD81126
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: