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NPI Code Detail

MEDICARE: DR. EMILY SANDBACH M.D.

MEDICARE: DR. EMILY SANDBACH M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianDR.0054701CO
2207R00000XInternal Medicine PhysicianDR.0054701CO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2388731YKRDOTHERCOMEDICARE NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033289285
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMILY SANDBACH M.D.
Provider Business Mailing Address
First Line : 3205 N ACADEMY BLVD
Second Line : SUITE 130
City : COLORADO SPRINGS
State : CO
Zip : 80917-5147
Country : US
Telephone Number : 719-632-5700
Fax Number :
Provider Business Practice Location Address
First Line : 5410 POWERS CENTER PT STE 230
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-7148
Country : US
Telephone Number : 719-282-6100
Fax Number : 719-282-6106
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2006
Last Update Date : 07/05/2023

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