Provider Demographics
NPI:1356575229
Name:NATSAG, JAVZANDULAM (MD, PHD)
Entity type:Individual
Prefix:
First Name:JAVZANDULAM
Middle Name:
Last Name:NATSAG
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10710 CHARTER DR STE 410
Mailing Address - Street 2:SUITE 410
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3276
Mailing Address - Country:US
Mailing Address - Phone:301-953-2080
Mailing Address - Fax:301-953-3543
Practice Address - Street 1:10710 CHARTER DR STE 410
Practice Address - Street 2:SUITE 410
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3276
Practice Address - Country:US
Practice Address - Phone:301-953-2080
Practice Address - Fax:301-953-3543
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0079225207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD418398ZA98Medicare UPIN