Provider Demographics
NPI:1801823703
Name:SABLOFF, JEFFEREY DENNIS (MD)
Entity Type:Individual
Prefix:
First Name:JEFFEREY
Middle Name:DENNIS
Last Name:SABLOFF
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 1:8926 WOODYARD ROAD
Mailing Address - Street 2:SUITE 701
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735
Mailing Address - Country:US
Mailing Address - Phone:301-856-1682
Mailing Address - Fax:301-856-0964
Practice Address - Street 1:8926 WOODYARD ROAD
Practice Address - Street 2:SUITE 701
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735
Practice Address - Country:US
Practice Address - Phone:301-856-1682
Practice Address - Fax:301-856-0964
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD9064207X00000X
VA01010248450207X00000X
MDD0017653207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00661248OtherRAILROAD MEDICARE PTAN
40073OtherMDIPA/OPT CHOICE/MAMSI #
MD420227OtherCAREFIRST OF MARYLAND
778483OtherUNITED HEALTHCARE PROV#
DC46950002OtherCAREFIRST NCA PROV#
P00661248OtherRAILROAD MEDICARE PTAN
DG8302Medicare PIN
DC176608Medicare ID - Type UnspecifiedMETRO MEDICARE PROV #
P00661248OtherRAILROAD MEDICARE PTAN
40073OtherMDIPA/OPT CHOICE/MAMSI #
0254450002Medicare NSC