1013029446 NPI number — DR. JOHN R SAUNDERS JR. M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013029446 NPI number — DR. JOHN R SAUNDERS JR. M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

SAUNDERS

Provider First Name:

JOHN

Provider Middle Name:

R

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

JR.

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1013029446

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

12/02/2011

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 418953

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

BOSTON

Provider Business Mailing Address State Name:

MA

Provider Business Mailing Address Postal Code:

02241-8953

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

6569 N CHARLES ST

Provider Second Line Business Practice Location Address:

SUITE 401

Provider Business Practice Location Address City Name:

BALTIMORE

Provider Business Practice Location Address State Name:

MD

Provider Business Practice Location Address Postal Code:

21204-6831

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

443-849-8940

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

08/31/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207Y00000X , with the licence number:  D28133 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 208600000X , with the licence number: D28133 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2086X0206X , with the licence number: D28133 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: S143/0002 . This is a "CAREFIRST REGIONAL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 1700537 . This is a "UHC AMERICHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 309631900 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
• Identifier: KJ32GB-42041402 . This is a "CAREFIRST MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 25857 . This is a "JOHNS HOPKINS EHP PP USFH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 116786 . This is a "KAISER PERM" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 935877 . This is a "MAMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: KG72GB-42041401 . This is a "CAREFIRST MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".