Healthcare Provider Details

I. General information

NPI: 1376573683
Provider Name (Legal Business Name): ABDULLAH SAKARCAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 06/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 WALNUT ST
WEST READING PA
19611
US

IV. Provider business mailing address

PO BOX 6946
READING PA
19610-0946
US

V. Phone/Fax

Practice location:
  • Phone: 484-345-3038
  • Fax: 610-372-0232
Mailing address:
  • Phone: 610-372-9222
  • Fax: 610-372-0232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License NumberC10009076
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number21533
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD434736
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: