Basic Information
| Provider Information | |||||||||
| NPI: | 1134579360 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NELSON | ||||||||
| FirstName: | SASHA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10710 CHARTER DR | ||||||||
| Address2: | STE 200 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210443259 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108848000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1627 CHEW ST | ||||||||
| Address2: | 1ST FLOOR | ||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181023648 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104021600 | ||||||||
| FaxNumber: | 6109692197 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2016 | ||||||||
| LastUpdateDate: | 06/11/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VX0000X | D89302 | MD | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics | 207V00000X | MT210475 | PA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.