Healthcare Provider Details

I. General information

NPI: 1760530893
Provider Name (Legal Business Name): JEFFREY MICHAEL SAUER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3917 WEST RD STE 135
LOS ALAMOS NM
87544-2275
US

IV. Provider business mailing address

3917 WEST RD STE 135
LOS ALAMOS NM
87544-2275
US

V. Phone/Fax

Practice location:
  • Phone: 505-662-2020
  • Fax: 505-662-9501
Mailing address:
  • Phone: 505-662-2020
  • Fax: 505-662-9501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number197
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: