Provider Demographics
NPI:1235100850
Name:SADLER, JOHN HOLLAND (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HOLLAND
Last Name:SADLER
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 1:840 HOLLINS ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1024
Mailing Address - Country:US
Mailing Address - Phone:410-468-0900
Mailing Address - Fax:410-468-0911
Practice Address - Street 1:840 HOLLINS ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1024
Practice Address - Country:US
Practice Address - Phone:410-468-0900
Practice Address - Fax:410-468-0911
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD14336207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD14336OtherSTATE LICENSE
MDMA-15001-1200Medicaid
MDD75327Medicare UPIN