Provider Demographics
NPI:1992871289
Name:TAIMUR, SADAF (MD)
Entity type:Individual
Prefix:MRS
First Name:SADAF
Middle Name:
Last Name:TAIMUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 B THOMAS JOHNSON DR SIITE # 200
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-5401
Mailing Address - Country:US
Mailing Address - Phone:301-695-6777
Mailing Address - Fax:301-695-4852
Practice Address - Street 1:46B THOMAS JOHNSON DR STE 200
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4501
Practice Address - Country:US
Practice Address - Phone:301-695-6777
Practice Address - Fax:301-695-4852
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD691961207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM05303290Medicaid
742823514OtherTAX ID
NM202002278OtherPRESBYTERIAN SALUD
NM10022967OtherLOVELACE SALUD & HEALTHPL
348521302Medicare ID - Type Unspecified
NM1238400001Medicare PIN
742823514OtherTAX ID