Healthcare Provider Details

I. General information

NPI: 1053321364
Provider Name (Legal Business Name): KARIN MARIA SANDVED MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 04/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W BRAMBLETON AVE STE 100
NORFOLK VA
23510-1115
US

IV. Provider business mailing address

PO BOX 7068
PORTSMOUTH VA
23707-0068
US

V. Phone/Fax

Practice location:
  • Phone: 757-627-6220
  • Fax: 757-627-0200
Mailing address:
  • Phone: 757-686-3516
  • Fax: 757-686-0541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101054901
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: