Healthcare Provider Details

I. General information

NPI: 1578172425
Provider Name (Legal Business Name): SARAH KRISTIN ANDERSEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2020
Last Update Date: 08/08/2020
Certification Date: 08/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4048 WEST 32ND AVENUE
VANCOUVER BC
V6S1Z6
CA

IV. Provider business mailing address

4048 WEST 32ND AVENUE
VANCOUVER BC
V6S1Z6
CA

V. Phone/Fax

Practice location:
  • Phone: 416-274-9686
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number029233
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: