Provider Demographics
NPI:1558406017
Name:BELLOR LEICHTLING SAWAY & SCHNEIDER PC
Entity Type:Organization
Organization Name:BELLOR LEICHTLING SAWAY & SCHNEIDER PC
Other - Org Name:COLUMBIA MEDICAL PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SOHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KHWAJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-964-6100
Mailing Address - Street 1:5450 KNOLL NORTH DR
Mailing Address - Street 2:SUITE 180
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2300
Mailing Address - Country:US
Mailing Address - Phone:410-964-6100
Mailing Address - Fax:
Practice Address - Street 1:5450 KNOLL NORTH DR
Practice Address - Street 2:SUITE 180
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2300
Practice Address - Country:US
Practice Address - Phone:410-964-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD407079800Medicaid
MDDD4489Medicare PIN
MD407079800Medicaid
MD006NMedicare PIN
MDZADTMedicare PIN