1134389612 NPI number — DR. MIRIAM SAAD LENDER MD

Table of content: DR. MIRIAM SAAD LENDER MD (NPI 1134389612)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134389612 NPI number — DR. MIRIAM SAAD LENDER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LENDER
Provider First Name:
MIRIAM
Provider Middle Name:
SAAD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SAAD
Provider Other First Name:
MIRIAM
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1134389612
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/21/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13575 HEATHCOTE BLVD
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
GAINESVILLE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20155
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
571-248-4620
Provider Business Mailing Address Fax Number:
571-248-4374

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13575 HEATHCOTE BLVD
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
GAINESVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20155
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
571-248-4620
Provider Business Practice Location Address Fax Number:
571-248-4374
Provider Enumeration Date:
06/10/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  0101253914 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208000000X , with the licence number: 0101253914 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 448201800 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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