Provider Demographics
NPI:1447600465
Name:YEWALE, SAYALI (MD)
Entity Type:Individual
Prefix:
First Name:SAYALI
Middle Name:
Last Name:YEWALE
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 1:37767 MARKET DR UNIT 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE HALL
Mailing Address - State:MD
Mailing Address - Zip Code:20622-3199
Mailing Address - Country:US
Mailing Address - Phone:301-884-7330
Mailing Address - Fax:301-884-7530
Practice Address - Street 1:37767 MARKET DR UNIT 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE HALL
Practice Address - State:MD
Practice Address - Zip Code:20622-3199
Practice Address - Country:US
Practice Address - Phone:301-884-7330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD86889208000000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty