Healthcare Provider Details

I. General information

NPI: 1093719353
Provider Name (Legal Business Name): KADAN C SAU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/02/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 MUSGROVE RD STE 308
SILVER SPRING MD
20904-5223
US

IV. Provider business mailing address

2415 MUSGROVE RD STE 308
SILVER SPRING MD
20904-5223
US

V. Phone/Fax

Practice location:
  • Phone: 301-236-9540
  • Fax: 301-236-9578
Mailing address:
  • Phone: 301-236-9540
  • Fax: 301-236-9578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0023734
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: