Provider Demographics
NPI:1396878716
Name:SUDHIR SEKHSARIA M. D. P.C.
Entity type:Organization
Organization Name:SUDHIR SEKHSARIA M. D. P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SUDHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:SEKHSARIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-933-9404
Mailing Address - Street 1:5430 CAMPBELL BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WHITE MARSH
Mailing Address - State:MD
Mailing Address - Zip Code:21162-5500
Mailing Address - Country:US
Mailing Address - Phone:410-933-9404
Mailing Address - Fax:410-933-9405
Practice Address - Street 1:5430 CAMPBELL BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:WHITE MARSH
Practice Address - State:MD
Practice Address - Zip Code:21162-5500
Practice Address - Country:US
Practice Address - Phone:410-933-9404
Practice Address - Fax:410-933-9405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0038106174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD457800700Medicaid
MDD0038106OtherSTATE LICENSE
MDBS1814373OtherDEA
MDBS1814373OtherDEA
MDD0038106OtherSTATE LICENSE