MEDICARE: SANDRA K HAREWOOD 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
1	207R00000X	Internal Medicine Physician	35.090989	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HA0825573	OTHER	OH	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	35.090989	OTHER	OH	STATE MEDICAL BOARD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063685014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA K HAREWOOD M.D.

Provider Business Mailing Address
First Line	:	235 W NATIONAL RD.
Second Line	:
City	:	VANDALIA
State	:	OH
Zip	:	45377-1969
Country	:	US
Telephone Number	:	937-898-3600
Fax Number	:	937-898-2731

Provider Business Practice Location Address
First Line	:	235 W NATIONAL RD
Second Line	:
City	:	VANDALIA
State	:	OH
Zip	:	45377-1969
Country	:	US
Telephone Number	:	937-898-3600
Fax Number	:	937-898-2731

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2008
Last Update Date	:	01/10/2023

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Directions to “ SANDRA K HAREWOOD M.D.” Practice Location

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