Provider Demographics
NPI:1033465695
Name:SANDOR, KRISTIAN LASZLO (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIAN
Middle Name:LASZLO
Last Name:SANDOR
Suffix:
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 1:3119 ROBERTS LNDG
Mailing Address - Street 2:
Mailing Address - City:FINKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21048-1352
Mailing Address - Country:US
Mailing Address - Phone:610-400-4253
Mailing Address - Fax:
Practice Address - Street 1:1314 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208
Practice Address - Country:US
Practice Address - Phone:610-400-4253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD78799207Q00000X
PAMT202981390200000X
MDD0078799208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program