Provider Demographics
NPI:1750303962
Name:SADDLER, STEPHEN C (MD)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:C
Last Name:SADDLER
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 1:2445 ARMY NAVY DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-2905
Mailing Address - Country:US
Mailing Address - Phone:703-892-6500
Mailing Address - Fax:703-769-8486
Practice Address - Street 1:8101 HINSON FARM ROAD
Practice Address - Street 2:SUITE 301
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306
Practice Address - Country:UM
Practice Address - Phone:301-856-1682
Practice Address - Fax:301-856-8214
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052798207X00000X, 204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00887809OtherRAILRAOD MEDICARE PTAN
786175YZWOtherMETRO MEDICARE
145530100OtherDEPARTMENT OF LABOR
46950042OtherCAREFIRST NCA
46950042OtherCAREFIRST NCA
0254450002Medicare NSC
CI2264Medicare PIN
P00887809OtherRAILRAOD MEDICARE PTAN
VA786175M02Medicare PIN