Provider Demographics
NPI:1750343505
Name:SAGIN, MARK ALLEN (MD PHYSICIAN AND SUR)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALLEN
Last Name:SAGIN
Suffix:
Gender:M
Credentials:MD PHYSICIAN AND SUR
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Mailing Address - Street 1:12502 WILLOWBROOK RD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-6393
Mailing Address - Country:US
Mailing Address - Phone:240-964-8750
Mailing Address - Fax:240-964-8699
Practice Address - Street 1:12502 WILLOWBROOK RD
Practice Address - Street 2:SUITE 280
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-6393
Practice Address - Country:US
Practice Address - Phone:240-964-8750
Practice Address - Fax:240-964-8699
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2010-06-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0035481207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD567B 420267-02OtherCAREFIRST OF MARYLAND
DCK307-0012OtherGHSMI
MD774141301Medicaid
B69726Medicare UPIN
MD567B 420267-02OtherCAREFIRST OF MARYLAND