Healthcare Provider Details

I. General information

NPI: 1790425270
Provider Name (Legal Business Name): ADAM SAHLSTROM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 ELM ST N
ONAMIA MN
56359-7901
US

IV. Provider business mailing address

11154 280TH ST
ONAMIA MN
56359-2928
US

V. Phone/Fax

Practice location:
  • Phone: 320-532-3154
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number83580
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: