Basic Information
| Provider Information | |||||||||
| NPI: | 1578636718 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SARKAR | ||||||||
| FirstName: | SAMEER | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | RAF LAKENHEATH 48 MDG/SGHC | ||||||||
| Address2: | UNIT 5115 | ||||||||
| City: | APO | ||||||||
| State: | AE | ||||||||
| PostalCode: | 094615115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3142268603 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | RAF LAKENHEATH 48 MDG/SGHC | ||||||||
| Address2: | UNIT 5115 | ||||||||
| City: | APO | ||||||||
| State: | AE | ||||||||
| PostalCode: | 094615115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3142268603 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 209982 | MA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084F0202X | 209982 | MA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Forensic Psychiatry |
No ID Information.