Provider Demographics
NPI:1710043765
Name:SANDLER, LAWRENCE DAVID (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:DAVID
Last Name:SANDLER
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 1:1501 SULGRAVE AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3654
Mailing Address - Country:US
Mailing Address - Phone:410-664-2909
Mailing Address - Fax:410-664-5870
Practice Address - Street 1:1501 SULGRAVE AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3654
Practice Address - Country:US
Practice Address - Phone:410-664-2909
Practice Address - Fax:410-664-5870
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00226232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD7411Medicare ID - Type Unspecified
MDD76802Medicare UPIN