Provider Demographics
NPI:1609237122
Name:SANDFORD, JANELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:JANELLE
Middle Name:
Last Name:SANDFORD
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:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:MD
Mailing Address - Zip Code:21797-0160
Mailing Address - Country:US
Mailing Address - Phone:410-549-3490
Mailing Address - Fax:
Practice Address - Street 1:733 BUCKHORN RD
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-9040
Practice Address - Country:US
Practice Address - Phone:410-549-3490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0039544208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics