Basic Information
| Provider Information | |||||||||
| NPI: | 1326171760 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SARINA | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2002 MEDICAL PKWY | ||||||||
| Address2: | SUITE 235 | ||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214013046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102662770 | ||||||||
| FaxNumber: | 4108416251 | ||||||||
| Practice Location | |||||||||
| Address1: | 2002 MEDICAL PKWY | ||||||||
| Address2: | SUITE 235 | ||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214013046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102662770 | ||||||||
| FaxNumber: | 4108416251 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2007 | ||||||||
| LastUpdateDate: | 08/29/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 0101244987 | VA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | D0066121 | MD | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 182936ZDYC | 01 | MD | RR MEDICARE ARA PTAN | OTHER | S645AN | 01 | MD | AAD MEDICARE | OTHER | P00897470 | 01 | MD | RR MEDICARE SHIPLEYS PROVIDER PTAN | OTHER | 182936ZD7B | 01 | MD | MEDICARE PTAN - AAD S645 | OTHER | P00897478 | 01 | MD | RR MEDICARE AAD PROVIDER PTAN | OTHER | 419952900 | 01 | MD | MEDICAID - AAD SHIPLEYS | OTHER | 9669378 | 01 | MD | AAD AETNA (SHIPLEYS) | OTHER | CN6292 | 01 | MD | RR MEDICARE SHIPLEYS GROUP PTAN | OTHER | KC46SH | 01 | MD | AAD MEDICARE SHIPLEYS | OTHER | 1073 | 01 | MD | AAD | OTHER | 3811 | 01 | MD | AAD SHIPLEYS | OTHER | 419952900 | 05 | MD | MEDICAID | CA1932 | 01 | MD | RR MEDICARE AAD GROUP PTAN | OTHER |