Provider Demographics
NPI:1982663399
Name:SATTIN, SANDRA G (MD)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:G
Last Name:SATTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 DORSEY HALL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7791
Mailing Address - Country:US
Mailing Address - Phone:410-461-7999
Mailing Address - Fax:410-461-7990
Practice Address - Street 1:5300 DORSEY HALL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7791
Practice Address - Country:US
Practice Address - Phone:410-461-7999
Practice Address - Fax:410-461-7990
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0035309207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD232571300Medicaid
MD354106-01OtherCAREFIRST-MD
MD0013OtherCAREFIRST-DC
MD539P085HMedicare PIN
MD0013OtherCAREFIRST-DC