Provider Demographics
NPI:1386704831
Name:SANDY, CARLA C (MD)
Entity type:Individual
Prefix:DR
First Name:CARLA
Middle Name:C
Last Name:SANDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CARLA
Other - Middle Name:A
Other - Last Name:CARGILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:4E - PROVIDER ENROLLMENT UNIT
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-2424
Mailing Address - Fax:
Practice Address - Street 1:12201 PLUM ORCHARD DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7803
Practice Address - Country:US
Practice Address - Phone:013-572-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD63361207V00000X
DCMD035342207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
017826K92Medicare ID - Type Unspecified
I39631Medicare UPIN