Healthcare Provider Details

I. General information

NPI: 1073907226
Provider Name (Legal Business Name): SANDEEP SANKINENI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2015
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 E. ORDNANCE RD STE 203-204
GLEN BURNIE MD
21061
US

IV. Provider business mailing address

717 E. ORDNANCE RD STE 203-204
GLEN BURNIE MD
21061
US

V. Phone/Fax

Practice location:
  • Phone: 866-578-7802
  • Fax:
Mailing address:
  • Phone: 866-578-7802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD046225
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD0085063
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0101264257
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD85063
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: