Healthcare Provider Details
I. General information
NPI: 1427142843
Provider Name (Legal Business Name): SANDY H OESTERREICHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/02/2006
Last Update Date: 09/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9224 TEDDY LANE #200
LONE TREE CO
80124-6799
US
IV. Provider business mailing address
720 S COLORADO BLVD SUITE 220A
GLENDALE CO
80246-1912
US
V. Phone/Fax
- Phone: 303-790-1515
- Fax: 303-790-1989
- Phone: 303-584-8231
- Fax: 866-210-0907
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0206X |
| Taxonomy | Pediatric Gastroenterology Physician |
| License Number | 43879 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: