Individual
DR. NATASHA AGNES SANDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8890 CENTRE PARK DRIVE, SUITE 300B, COLUMBIA, MD 21045-2104
(410) 696-7553
Mailing address
2710 GOODWOOD RD, BALTIMORE, MD 21214-2109
(410) 696-7553
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
263711
NY
207N00000X
Dermatology Physician
Primary
D0071050
MD
207Q00000X
Family Medicine Physician
25MA08428600
NJ
207Q00000X
Family Medicine Physician
263711
NY
207Q00000X
Family Medicine Physician
D0071050
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA08428600
LICENCSE
NJ
01
—
263711
NY LIC
NY
01
—
D0071050
MARYLAND LICENSE
MD
Enumeration date
07/29/2008
Last updated
02/12/2020
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