Provider Demographics
NPI:1508932666
Name:SAHDEV, PRADIP (MD FACS FICS)
Entity Type:Individual
Prefix:DR
First Name:PRADIP
Middle Name:
Last Name:SAHDEV
Suffix:
Gender:M
Credentials:MD FACS FICS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 OLD WASHINGTON ROAD STE 202
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602
Mailing Address - Country:US
Mailing Address - Phone:301-645-3590
Mailing Address - Fax:301-705-1941
Practice Address - Street 1:3450 OLD WASHINGTON ROAD STE 202
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602
Practice Address - Country:US
Practice Address - Phone:301-645-3590
Practice Address - Fax:301-705-1941
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0047202208600000X, 2086S0102X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD725501200Medicaid
MD725501200Medicaid
MD579M894FMedicare PIN