Provider Demographics
NPI:1740228303
Name:VILAS R. SARPATWARI, MD, LLC
Entity Type:Organization
Organization Name:VILAS R. SARPATWARI, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VILAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:SARPATWARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-364-2500
Mailing Address - Street 1:16 PINEWOOD FARM CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-2339
Mailing Address - Country:US
Mailing Address - Phone:240-364-2500
Mailing Address - Fax:
Practice Address - Street 1:6502 KENILWORTH AVE # 200
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1340
Practice Address - Country:US
Practice Address - Phone:240-364-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD407563300Medicaid
MD407563300Medicaid