Provider Demographics
NPI:1194474197
Name:KASANGA, SADAT BA IFAN (MBCHB)
Entity type:Individual
Prefix:DR
First Name:SADAT
Middle Name:BA IFAN
Last Name:KASANGA
Suffix:
Gender:M
Credentials:MBCHB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 LEE ST BOX 800546
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22908-8016
Mailing Address - Country:US
Mailing Address - Phone:434-924-5219
Mailing Address - Fax:434-244-7509
Practice Address - Street 1:1215 LEE ST BOX 800546
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-8016
Practice Address - Country:US
Practice Address - Phone:434-924-5219
Practice Address - Fax:434-244-7509
Is Sole Proprietor?:No
Enumeration Date:2022-03-18
Last Update Date:2025-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116040269390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program