Provider Demographics
NPI:1013029446
Name:SAUNDERS, JOHN R JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:SAUNDERS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 418953
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-8953
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6569 N CHARLES ST
Practice Address - Street 2:SUITE 401
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-6831
Practice Address - Country:US
Practice Address - Phone:443-849-8940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD28133207Y00000X, 208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS143/0002OtherCAREFIRST REGIONAL
MD1700537OtherUHC AMERICHOICE
MD309631900Medicaid
MDKJ32GB-42041402OtherCAREFIRST MARYLAND
MD25857OtherJOHNS HOPKINS EHP PP USFH
MD116786OtherKAISER PERM
MD935877OtherMAMSI
MDKG72GB-42041401OtherCAREFIRST MARYLAND
MD309631900Medicaid
MDS143/0002OtherCAREFIRST REGIONAL
MD25857OtherJOHNS HOPKINS EHP PP USFH
D74434Medicare UPIN