Basic Information
Provider Information
NPI: 1649237629
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAPORITO
FirstName: LOUIS
MiddleName: J.
NamePrefix: DR.
NameSuffix: III
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3116 FAIRWEATHER CT
Address2:  
City: OLNEY
State: MD
PostalCode: 208323021
CountryCode: US
TelephoneNumber: 3017747522
FaxNumber:  
Practice Location
Address1: 8901 WISCONSIN AVE
Address2: INTERNAL MEDICINE CLINIC, NATIONAL NAVAL MEDICAL CENTER
City: BETHESDA
State: MD
PostalCode: 208890001
CountryCode: US
TelephoneNumber: 3012954630
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/26/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XG56834CAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


Home