Healthcare Provider Details

I. General information

NPI: 1043210412
Provider Name (Legal Business Name): PADMINI SAGAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 11/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8114 HARFORD RD
PARKVILLE MD
21234-5796
US

IV. Provider business mailing address

8114 HARFORD RD
PARKVILLE MD
21234-5796
US

V. Phone/Fax

Practice location:
  • Phone: 410-661-5800
  • Fax: 410-665-4179
Mailing address:
  • Phone: 410-661-5800
  • Fax: 410-665-4179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0064586
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: