Doctor Name: | DR. SANDRA MILENA PEYNADO |
NPI Number: | 1134354764 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | SDTP22 |
Business Practice Address: | 1400 W 22nd St Sioux Falls, SD - 571051505 |
Business Phone Number: | 6053671300 |
Business Fax Number: | |
Mailing Address: | 8407 Ramath Dr, CHARLOTTE |
State: | NC |
Postal Code: | 282115654 |
Phone Number: | 7046081853 |
Fax Number: | |
NPI Enumeration Date: | 05/27/2009 |
NPI Last Update Date: | 05/27/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | SDTP22 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SD |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |