Provider Demographics
NPI:1306995907
Name:SAXENA, PREETI (MD)
Entity type:Individual
Prefix:DR
First Name:PREETI
Middle Name:
Last Name:SAXENA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PREETI
Other - Middle Name:
Other - Last Name:RASTOGI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1138 OPAL CT
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5940
Mailing Address - Country:US
Mailing Address - Phone:301-745-4500
Mailing Address - Fax:301-745-4659
Practice Address - Street 1:1138 OPAL CT
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5940
Practice Address - Country:US
Practice Address - Phone:301-745-4500
Practice Address - Fax:301-745-4659
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0056714207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD400753100Medicaid
MD198NM076Medicare ID - Type UnspecifiedMEDICARE NUMBER
MD400753100Medicaid