Healthcare Provider Details

I. General information

NPI: 1972509909
Provider Name (Legal Business Name): SANDRA L ZILA-EIVINS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SANDRA L. EIVINS M.D.

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date: 03/16/2006
Reactivation Date: 04/03/2006

III. Provider practice location address

940 CENTRAL PARK DR STE 210
STEAMBOAT SPRINGS CO
80487-8816
US

IV. Provider business mailing address

940 CENTRAL PARK DR STE 210
STEAMBOAT SPRINGS CO
80487-8816
US

V. Phone/Fax

Practice location:
  • Phone: 970-871-4811
  • Fax: 970-879-4527
Mailing address:
  • Phone: 970-871-4811
  • Fax: 970-879-4527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number36567
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: