Healthcare Provider Details

I. General information

NPI: 1861170193
Provider Name (Legal Business Name): DONNA SARARA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2023
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 ANNAPOLIS RD STE 100
ODENTON MD
21113-1622
US

IV. Provider business mailing address

4900 LYON HEART DR APT 1
OWINGS MILLS MD
21117-6190
US

V. Phone/Fax

Practice location:
  • Phone: 410-672-2255
  • Fax: 410-816-9472
Mailing address:
  • Phone: 484-554-8947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0009343
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: