Provider Demographics
NPI:1043210412
Name:SAGAR, PADMINI (MD)
Entity Type:Individual
Prefix:
First Name:PADMINI
Middle Name:
Last Name:SAGAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8114 HARFORD RD
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-5796
Mailing Address - Country:US
Mailing Address - Phone:410-661-5800
Mailing Address - Fax:410-665-4179
Practice Address - Street 1:8114 HARFORD RD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-5796
Practice Address - Country:US
Practice Address - Phone:410-661-5800
Practice Address - Fax:410-665-4179
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0064586208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
232460YEVBOtherMEDICARE NUMBER
MD422388800Medicaid
NY56709RMedicare PIN