Basic Information
Provider Information | |||||||||
NPI: | 1689654824 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SARKAR | ||||||||
FirstName: | SAIYAD | ||||||||
MiddleName: | ALEEM | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 400 REDLAND COURT | ||||||||
Address2: | SUITE 208 | ||||||||
City: | OWINGS MILLS | ||||||||
State: | MD | ||||||||
PostalCode: | 211173292 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4104947921 | ||||||||
FaxNumber: | 4109028247 | ||||||||
Practice Location | |||||||||
Address1: | 9103 FRANKLIN SQUARE BLVD. | ||||||||
Address2: | SUITE 300 | ||||||||
City: | BALTIMORE | ||||||||
State: | MD | ||||||||
PostalCode: | 212373939 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4106825282 | ||||||||
FaxNumber: | 4106825286 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 01/21/2006 | ||||||||
LastUpdateDate: | 08/28/2012 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | D62065 | MD | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RC0200X | D62065 | MD | N |   | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
ID Information
ID | Type | State | Issuer | Description | K531Q373 | 01 | MD | MEDICARE PTAN | OTHER | 408855700 | 05 | MD |   | MEDICAID |