1881431815 NPI number — MR. DONTAY ROY LEE SAUNDERS LMT

Table of content: MR. DONTAY ROY LEE SAUNDERS LMT (NPI 1881431815)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881431815 NPI number — MR. DONTAY ROY LEE SAUNDERS LMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAUNDERS
Provider First Name:
DONTAY
Provider Middle Name:
ROY LEE
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LMT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SAUNDERS
Provider Other First Name:
DONTAY
Provider Other Middle Name:
ROY LEE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMT
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1881431815
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
821 CHESAPEAKE AVE. #4158
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANNAPOLIS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21403-3285
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-254-2862
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4037 BRANCH AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TEMPLE HILLS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20748
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-316-2111
Provider Business Practice Location Address Fax Number:
301-316-5382
Provider Enumeration Date:
07/09/2024

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: 2081S0010X , with the licence number:  M06655 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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