Healthcare Provider Details

I. General information

NPI: 1306995907
Provider Name (Legal Business Name): PREETI SAXENA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PREETI RASTOGI MD

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 01/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1138 OPAL CT
HAGERSTOWN MD
21740-5940
US

IV. Provider business mailing address

1138 OPAL CT
HAGERSTOWN MD
21740-5940
US

V. Phone/Fax

Practice location:
  • Phone: 301-745-4500
  • Fax: 301-745-4659
Mailing address:
  • Phone: 301-745-4500
  • Fax: 301-745-4659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0056714
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: