Provider Demographics
NPI:1033238316
Name:SADR, NEGAR NIKKI (MD)
Entity Type:Individual
Prefix:
First Name:NEGAR
Middle Name:NIKKI
Last Name:SADR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:844 KEMPSVILLE RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3927
Mailing Address - Country:US
Mailing Address - Phone:757-461-3890
Mailing Address - Fax:757-461-0836
Practice Address - Street 1:844 KEMPSVILLE RD
Practice Address - Street 2:SUITE 208
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3927
Practice Address - Country:US
Practice Address - Phone:757-461-3890
Practice Address - Fax:757-461-0836
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101241252207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1114965043Medicare PIN