Provider Demographics
NPI:1962452045
Name:VAZER, SARA AZRA (MD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:AZRA
Last Name:VAZER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15825 SHADY GROVE RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4008
Mailing Address - Country:US
Mailing Address - Phone:301-869-9776
Mailing Address - Fax:301-216-2592
Practice Address - Street 1:15825 SHADY GROVE RD
Practice Address - Street 2:SUITE 140
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4008
Practice Address - Country:US
Practice Address - Phone:301-869-9776
Practice Address - Fax:301-216-2592
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0061298207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD64121204OtherBSMD PROVIDER NUMBER
MD7616515OtherAETNA PPO PROVIDER NUMBER
MD8302825OtherCIGNA PROVIDER NUMBER
MD8127030OtherALLIANCE PROVIDER NUMBER
MD9070 0019OtherBSDC PROVIDER NUMBER
MD8127030OtherMAMSI PROVIDER NUMBER
MD8127030OtherMDIPA PROVIDER NUMBER
MD8127030OtherOPTIMUM CHOICE PROV #
MD521186611OtherUNITED HEALTHCARE PROV #
MD7616515OtherAETNA HMO PROVIDER NUMBER
MD8127030OtherOPTIMUM CHOICE PROV #
MD521186611OtherUNITED HEALTHCARE PROV #