Healthcare Provider Details

I. General information

NPI: 1366602625
Provider Name (Legal Business Name): SARAH ANNE SANDBERG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2008
Last Update Date: 11/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3980 COLONNADE PKWY
BIRMINGHAM AL
35243-2382
US

IV. Provider business mailing address

1130 22ND ST S STE 1000
BIRMINGHAM AL
35205-2881
US

V. Phone/Fax

Practice location:
  • Phone: 205-795-5390
  • Fax: 205-599-9081
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number38784
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: