Provider Demographics
NPI:1578510392
Name:SADER, CLAUDE-LAURENT (MD)
Entity type:Individual
Prefix:
First Name:CLAUDE-LAURENT
Middle Name:
Last Name:SADER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3129
Mailing Address - Country:US
Mailing Address - Phone:508-778-1829
Mailing Address - Fax:508-778-0113
Practice Address - Street 1:25 MAIN ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3129
Practice Address - Country:US
Practice Address - Phone:508-778-1829
Practice Address - Fax:508-778-0113
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA234460207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1578510392OtherCIGNA
MA11174061OtherCAQH
MA1578510392OtherAETNA
MA1578510392Medicaid
MAAA109234OtherHARVARD PILGRIM
MA1578510392OtherMEDICARE ID- TYPED UNSPECIFIED
MA1578510392OtherTRICARE
MA1578510392OtherUNICARE
MA1578510392OtherBOSTON MEDICAL CENTER
MA1578510392OtherTUFTS
MA1578510392OtherNETWORK HEALTH
MA1578510392OtherMEDICARE ID
MA1578510392OtherBLUE CROSS BLUE SHIELD
MA1578510392OtherTUFTS