Provider Demographics
NPI:1134389612
Name:LENDER, MIRIAM SAAD (MD)
Entity type:Individual
Prefix:DR
First Name:MIRIAM
Middle Name:SAAD
Last Name:LENDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MIRIAM
Other - Middle Name:
Other - Last Name:SAAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:13575 HEATHCOTE BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155
Mailing Address - Country:US
Mailing Address - Phone:571-248-4620
Mailing Address - Fax:571-248-4374
Practice Address - Street 1:13575 HEATHCOTE BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155
Practice Address - Country:US
Practice Address - Phone:571-248-4620
Practice Address - Fax:571-248-4374
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101253914207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD448201800Medicaid