Provider Demographics
NPI:1326171760
Name:SARINA, AMY E (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:E
Last Name:SARINA
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 1:2002 MEDICAL PKWY
Mailing Address - Street 2:SUITE 235
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3046
Mailing Address - Country:US
Mailing Address - Phone:410-266-2770
Mailing Address - Fax:410-841-6251
Practice Address - Street 1:2002 MEDICAL PKWY
Practice Address - Street 2:SUITE 235
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3046
Practice Address - Country:US
Practice Address - Phone:410-266-2770
Practice Address - Fax:410-841-6251
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012449872085R0202X
MDD00661212085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD182936ZDYCOtherRR MEDICARE ARA PTAN
MDS645ANOtherAAD MEDICARE
MDP00897470OtherRR MEDICARE SHIPLEYS PROVIDER PTAN
MD182936ZD7BOtherMEDICARE PTAN - AAD S645
MDP00897478OtherRR MEDICARE AAD PROVIDER PTAN
MD419952900OtherMEDICAID - AAD SHIPLEYS
MD9669378OtherAAD AETNA (SHIPLEYS)
MDCN6292OtherRR MEDICARE SHIPLEYS GROUP PTAN
MDKC46SHOtherAAD MEDICARE SHIPLEYS
MD1073OtherAAD
MD3811OtherAAD SHIPLEYS
MD419952900Medicaid
MDCA1932OtherRR MEDICARE AAD GROUP PTAN
MD1073OtherAAD
MDCN6292OtherRR MEDICARE SHIPLEYS GROUP PTAN