Provider Demographics
NPI:1417001462
Name:GENSER, SANDER GARY (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDER
Middle Name:GARY
Last Name:GENSER
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 1:8905 WANDERING TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2379
Mailing Address - Country:US
Mailing Address - Phone:301-369-1340
Mailing Address - Fax:301-369-1340
Practice Address - Street 1:8905 WANDERING TRAIL DR
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-2379
Practice Address - Country:US
Practice Address - Phone:301-369-1340
Practice Address - Fax:301-340-7247
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00178602084P0802X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry