Provider Demographics
NPI:1639274517
Name:QUARTNER, SANDRA D (MD)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:D
Last Name:QUARTNER
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 1:6569 N CHARLES ST
Mailing Address - Street 2:STE 304
Mailing Address - City:BALTO
Mailing Address - State:MD
Mailing Address - Zip Code:21204
Mailing Address - Country:US
Mailing Address - Phone:410-339-3904
Mailing Address - Fax:410-825-4076
Practice Address - Street 1:6569 N CHARLES ST
Practice Address - Street 2:STE 304
Practice Address - City:BALTO
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-339-3904
Practice Address - Fax:410-825-4076
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0019922207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C57388Medicare UPIN
256QMedicare ID - Type Unspecified