Provider Demographics
NPI:1639104201
Name:SARADA, KAMAL K (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMAL
Middle Name:K
Last Name:SARADA
Suffix:
Gender:M
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 17383
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-1383
Mailing Address - Country:US
Mailing Address - Phone:410-328-5656
Mailing Address - Fax:410-328-2115
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:ROOM N2E16
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-5656
Practice Address - Fax:410-328-2115
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4317742085R0202X
MDD644522085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM60740OtherCDS #
MDBS9796991OtherFEDERAL DEA