Individual
SAMMIR PEREZ SANJUANELO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6103 BALTIMORE AVE STE T1, RIVERDALE, MD 20737-1966
(301) 277-2779
(301) 277-6947
Mailing address
6103 BALTIMORE AVE STE T1, RIVERDALE, MD 20737-1966
(301) 277-2779
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
271399
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
082399600
MEDICAL ASSISTANCE
MD
01
—
1209422
AMERICHOICE
MD
01
—
F4890001
CREFIRST
DC
01
—
FTX6EF65039006
CAREFIRST
MD
Enumeration date
05/24/2013
Last updated
06/13/2025
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