Provider Demographics
NPI:1154470771
Name:HAGERSTOWN FAMILY MEDICINE, PC
Entity Type:Organization
Organization Name:HAGERSTOWN FAMILY MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAXENA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-745-4500
Mailing Address - Street 1:1138 OPAL CT
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5940
Mailing Address - Country:US
Mailing Address - Phone:301-745-4500
Mailing Address - Fax:301-745-4659
Practice Address - Street 1:1138 OPAL CT
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5940
Practice Address - Country:US
Practice Address - Phone:301-745-4500
Practice Address - Fax:301-745-4659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD198NMedicare ID - Type UnspecifiedMEDICARE