Healthcare Provider Details

I. General information

NPI: 1972699163
Provider Name (Legal Business Name): MARK SAUERWEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 12/20/2021
Certification Date: 12/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 N ARROWLEAF TRL
SISTERS OR
97759
US

IV. Provider business mailing address

2500 NE NEFF RD
BEND OR
97701-6015
US

V. Phone/Fax

Practice location:
  • Phone: 541-549-1318
  • Fax:
Mailing address:
  • Phone: 541-382-4321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00023742
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: