Healthcare Provider Details

I. General information

NPI: 1396718250
Provider Name (Legal Business Name): SANDRA S ENGWALL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SANDRA LOUISE SESSIONS MD

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 12/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6845 LEE AVE N - MAIL STOP 31400A HEALTHPARTNERS BROOKLYN CENTER CLINIC
BROOKLYN CENTER MN
55429-1717
US

IV. Provider business mailing address

8170 33RD AVE S MS21110Q
MINNEAPOLIS MN
55425-4516
US

V. Phone/Fax

Practice location:
  • Phone: 763-503-4400
  • Fax: 763-503-4395
Mailing address:
  • Phone: 952-883-5375
  • Fax: 763-569-0311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number27983
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: