Provider Demographics
NPI:1942211412
Name:SAGGAR, TARA (MD)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:SAGGAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10403 HOSPITAL DR
Mailing Address - Street 2:SUITE G4
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-3134
Mailing Address - Country:US
Mailing Address - Phone:301-856-3019
Mailing Address - Fax:301-856-9370
Practice Address - Street 1:10 SAINT PATRICKS DR
Practice Address - Street 2:SUITE 203
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4527
Practice Address - Country:US
Practice Address - Phone:301-843-0222
Practice Address - Fax:301-846-0651
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2009-07-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0066719207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKR10OtherMARYLAND MEDICARE GROUP # FOR MEDICAL AND SURGICAL CLINICS OF SOUTHERN MARYLAND
MD1780629683OtherGROUP NPI - WALDORF FAMILY MEDICAL CENTER
DCB776-0032OtherBCBS DC
MD1851473722OtherGROUP NPI - MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND
MD92463701OtherBCBS MD
I46792Medicare UPIN
MD1780629683OtherGROUP NPI - WALDORF FAMILY MEDICAL CENTER