Provider Demographics
NPI:1922072198
Name:SANDERS, REGINALD J (MD)
Entity Type:Individual
Prefix:DR
First Name:REGINALD
Middle Name:J
Last Name:SANDERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7501 GREENWAY CENTER DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3514
Mailing Address - Country:US
Mailing Address - Phone:301-474-4679
Mailing Address - Fax:301-474-7182
Practice Address - Street 1:7501 GREENWAY CENTER DR
Practice Address - Street 2:SUITE 300
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3514
Practice Address - Country:US
Practice Address - Phone:301-441-4577
Practice Address - Fax:301-220-0396
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2017-07-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0041775207W00000X, 207WX0107X
DCMD18984207W00000X, 207WX0107X
VA0101046871207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006307001Medicaid
MD158751000Medicaid
VA006307043Medicaid
DC024859200Medicaid
VA006307043Medicaid
VA006307001Medicaid