Healthcare Provider Details

I. General information

NPI: 1447785944
Provider Name (Legal Business Name): SANDRA A COLE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SANDRA A TOTH MD

II. Dates (important events)

Enumeration Date: 04/22/2017
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 PINE RIDGE BLVD
WAUSAU WI
54401-7803
US

IV. Provider business mailing address

2400 PINE RIDGE BLVD
WAUSAU WI
54401-7803
US

V. Phone/Fax

Practice location:
  • Phone: 715-847-2022
  • Fax:
Mailing address:
  • Phone: 715-847-2022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number103469
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number87034
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number4301506670
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: