Provider Demographics
NPI:1215006994
Name:SINNO, FADY (MD)
Entity Type:Individual
Prefix:DR
First Name:FADY
Middle Name:
Last Name:SINNO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5300 DORSEY HALL DR
Mailing Address - Street 2:STE 102
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7819
Mailing Address - Country:US
Mailing Address - Phone:410-884-4200
Mailing Address - Fax:410-715-8534
Practice Address - Street 1:5300 DORSEY HALL DR
Practice Address - Street 2:STE 102
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7819
Practice Address - Country:US
Practice Address - Phone:410-884-4200
Practice Address - Fax:410-715-8534
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD35889208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD54258802OtherCAREFIRST BLUE CROSS BLUE
MD341680OtherMAMSI
MD502900700Medicaid
MD54258802OtherCAREFIRST BLUE CROSS BLUE
632QMedicare ID - Type Unspecified