Provider Demographics
NPI:1962555797
Name:SADIKMAN, JESSE CHAIM (MD)
Entity type:Individual
Prefix:DR
First Name:JESSE
Middle Name:CHAIM
Last Name:SADIKMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:121 CONGRESSIONAL LN STE 204
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1542
Mailing Address - Country:US
Mailing Address - Phone:301-545-1000
Mailing Address - Fax:301-545-1010
Practice Address - Street 1:121 CONGRESSIONAL LN
Practice Address - Street 2:SUITE 402
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1542
Practice Address - Country:US
Practice Address - Phone:301-545-1000
Practice Address - Fax:301-545-1010
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0060044207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM53471OtherCDS
MDM53471OtherCDS