Provider Demographics
NPI:1811762180
Name:SADDY, MINATA (MLS MHA SSM)
Entity type:Individual
Prefix:
First Name:MINATA
Middle Name:
Last Name:SADDY
Suffix:
Gender:F
Credentials:MLS MHA SSM
Other - Prefix:
Other - First Name:MINATA
Other - Middle Name:
Other - Last Name:SANGARE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MLS MHA
Mailing Address - Street 1:13562 WATERFORD HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-4654
Mailing Address - Country:US
Mailing Address - Phone:240-299-6339
Mailing Address - Fax:
Practice Address - Street 1:14816 PHYSICIANS LN STE 252
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3967
Practice Address - Country:US
Practice Address - Phone:443-430-0204
Practice Address - Fax:240-238-6787
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory