Doctor Name: | SANDRA SEWARD |
NPI Number: | 1033494992 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CSFA |
License Number: | 007339 |
Business Practice Address: | 11 Calle Pinon Placitas, NM - 870439316 |
Business Phone Number: | 5054015264 |
Business Fax Number: | |
Mailing Address: | Po Box 1956, BERNALILLO |
State: | NM |
Postal Code: | 870041956 |
Phone Number: | 5054015264 |
Fax Number: | |
NPI Enumeration Date: | 10/11/2011 |
NPI Last Update Date: | 02/23/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 007339 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |