Active NPI
Marc Samuel Sageman, M.D., PH.D.
- Psychiatry Physician
- Rockville, MD
National Provider Identifier
1720330566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- D0064356
- Practice address
- 507 Grand Champion Dr
Rockville, MD 20850-5791 - Phone
- (301) 990-8692
- NPI assigned
- Oct 3, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | D0064356 | MD | Primary |
Addresses
Primary practice location
507 Grand Champion Dr
Rockville, MD 20850-5791
Mailing address
402 King Farm Blvd
Suite 125-222
Rockville, MD 20850-5843
Phone (301) 990-8692
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0064356 | MD | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349222400000",
"number": "1720330566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 KING FARM BLVD",
"address_2": "SUITE 125-222",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208505843",
"telephone_number": "301-990-8692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "507 GRAND CHAMPION DR",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208505791",
"telephone_number": "301-990-8692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAGEMAN",
"first_name": "MARC",
"middle_name": "SAMUEL",
"name_prefix": "Dr.",
"credential": "M.D., PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-10-03",
"last_updated": "2012-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MD",
"license": "D0064356",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.