Provider Demographics
NPI:1528060837
Name:SARGEANT, JOHN B (PT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:B
Last Name:SARGEANT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1939 OLD ANNAPOLIS RD
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:MD
Mailing Address - Zip Code:21797-8201
Mailing Address - Country:US
Mailing Address - Phone:301-854-6748
Mailing Address - Fax:
Practice Address - Street 1:6000 EXECUTIVE BLVD
Practice Address - Street 2:STE 201
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3803
Practice Address - Country:US
Practice Address - Phone:301-816-0020
Practice Address - Fax:301-816-0334
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14262225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0129008OtherAETNA HMO
MD4296824OtherAETNA PPO
MDK366OtherBC/BS NON PROVIDER#
MD4074069OtherCIGNA
MD230033OtherUNITED HEALTHCARE
MD38311OtherMDIPA/ALLIANCE/MLH/OC
MD4296824OtherAETNA PPO
MD38311OtherMDIPA/ALLIANCE/MLH/OC