Provider Demographics
NPI:1043282189
Name:PARKINSON, SANDRA J (MD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:J
Last Name:PARKINSON
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:PO BOX 277045
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-7045
Mailing Address - Country:US
Mailing Address - Phone:301-698-8374
Mailing Address - Fax:301-698-0182
Practice Address - Street 1:850 OAK ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-8442
Practice Address - Country:US
Practice Address - Phone:301-698-8374
Practice Address - Fax:301-698-0182
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0035884207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1368054OtherAETNA PVN
2601736OtherUNITED
F242-0008OtherCAREFIRST BCBS GHMSI
418972-03OtherCAREFIRST BCBS MARYLAND
418972-03OtherCAREFIRST BCBS MARYLAND
418972-03OtherCAREFIRST BCBS MARYLAND
2601736OtherUNITED