Provider Demographics
NPI:1427260579
Name:LANTZY, SARAH S (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:S
Last Name:LANTZY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:S
Other - Last Name:WAREHIME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:45 THOMAS JOHNSON DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4425
Mailing Address - Country:US
Mailing Address - Phone:301-696-1000
Mailing Address - Fax:410-338-3050
Practice Address - Street 1:45 THOMAS JOHNSON DR
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4425
Practice Address - Country:US
Practice Address - Phone:301-696-1000
Practice Address - Fax:410-338-3050
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD436688207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023320020005Medicaid
PA1023320020005Medicaid