Provider Demographics
NPI:1861170193
Name:SARARA, DONNA
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:SARARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 LYON HEART DR APT 1
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-6190
Mailing Address - Country:US
Mailing Address - Phone:484-554-8947
Mailing Address - Fax:
Practice Address - Street 1:1130 ANNAPOLIS RD STE 100
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-1622
Practice Address - Country:US
Practice Address - Phone:410-672-2255
Practice Address - Fax:410-816-9472
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-07
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0009343207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty