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NPI Code Detail

MEDICARE: JEREMY SANDBERG DO

MEDICARE: JEREMY SANDBERG DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician2026021219MO

General Provider Information

NPI Number : 1457094807
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEREMY SANDBERG DO
Provider Business Mailing Address
First Line : 405 W GRAND AVE
Second Line :
City : DAYTON
State : OH
Zip : 45405-7538
Country : US
Telephone Number : 937-723-3245
Fax Number :
Provider Business Practice Location Address
First Line : 405 W GRAND AVE
Second Line :
City : DAYTON
State : OH
Zip : 45405-7538
Country : US
Telephone Number : 937-723-3245
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2022
Last Update Date : 05/29/2026

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Directions to “ JEREMY SANDBERG DO” Practice Location

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