Provider Demographics
NPI:1235748799
Name:AWAN, SARA ALTAF (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ALTAF
Last Name:AWAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3001 HOSPITAL DR FL 5
Mailing Address - Street 2:
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1189
Mailing Address - Country:US
Mailing Address - Phone:301-618-3772
Mailing Address - Fax:301-618-2986
Practice Address - Street 1:4240 ALTAMONT PLACE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695
Practice Address - Country:US
Practice Address - Phone:301-373-7900
Practice Address - Fax:301-373-6900
Is Sole Proprietor?:No
Enumeration Date:2020-07-30
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD96460207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program