Basic Information
| Provider Information | |||||||||
| NPI: | 1962452045 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VAZER | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | AZRA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15825 SHADY GROVE RD | ||||||||
| Address2: | SUITE 140 | ||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208504008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018699776 | ||||||||
| FaxNumber: | 3012162592 | ||||||||
| Practice Location | |||||||||
| Address1: | 15825 SHADY GROVE RD | ||||||||
| Address2: | SUITE 140 | ||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208504008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018699776 | ||||||||
| FaxNumber: | 3012162592 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2006 | ||||||||
| LastUpdateDate: | 07/30/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | D0061298 | MD | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 64121204 | 01 | MD | BSMD PROVIDER NUMBER | OTHER | 7616515 | 01 | MD | AETNA PPO PROVIDER NUMBER | OTHER | 8302825 | 01 | MD | CIGNA PROVIDER NUMBER | OTHER | 8127030 | 01 | MD | ALLIANCE PROVIDER NUMBER | OTHER | 9070 0019 | 01 | MD | BSDC PROVIDER NUMBER | OTHER | 8127030 | 01 | MD | MAMSI PROVIDER NUMBER | OTHER | 8127030 | 01 | MD | MDIPA PROVIDER NUMBER | OTHER | 8127030 | 01 | MD | OPTIMUM CHOICE PROV # | OTHER | 521186611 | 01 | MD | UNITED HEALTHCARE PROV # | OTHER | 7616515 | 01 | MD | AETNA HMO PROVIDER NUMBER | OTHER |