Provider Demographics
NPI:1508812991
Name:KAUSIK, SANKAR J (MD)
Entity Type:Individual
Prefix:
First Name:SANKAR
Middle Name:J
Last Name:KAUSIK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:25 CROSSROADS DR
Mailing Address - Street 2:SUITE 306
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5421
Mailing Address - Country:US
Mailing Address - Phone:410-803-0089
Mailing Address - Fax:410-803-0251
Practice Address - Street 1:201 PLUMTREE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6053
Practice Address - Country:US
Practice Address - Phone:410-803-0089
Practice Address - Fax:410-803-0251
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2014-04-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD58642208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD512800500Medicaid
MD731LD505Medicare PIN
MDG63687Medicare UPIN
MD914LD504Medicare PIN