Provider Demographics
NPI:1003815424
Name:SAURI, MICHAEL ANTHONY (MD, MPH&TM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:SAURI
Suffix:
Gender:M
Credentials:MD, MPH&TM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:15005 SHADY GROVE RD
Mailing Address - Street 2:SUITE 450
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6340
Mailing Address - Country:US
Mailing Address - Phone:301-738-6420
Mailing Address - Fax:301-738-2215
Practice Address - Street 1:15005 SHADY GROVE ROAD
Practice Address - Street 2:SUITE 450
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6340
Practice Address - Country:US
Practice Address - Phone:301-738-6420
Practice Address - Fax:301-738-2215
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-18
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD35404207PT0002X, 207R00000X, 207RI0200X, 2083P0901X, 2083T0002X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical Toxicology
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No2083T0002XAllopathic & Osteopathic PhysiciansPreventive MedicineMedical Toxicology
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD52-1534800OtherTAXPAYER ID NUMBER
MD28214Medicaid
MD52-1534800OtherTAXPAYER ID NUMBER
MDSA508296Medicare ID - Type Unspecified