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NPI Code Detail

MEDICARE: DR. DAVID JAY SAND MD

MEDICARE:  DR. DAVID JAY SAND  MD
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
1207YX0905XOtolaryngology/Facial Plastic Surgery Physician66490OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
151254OTHERNJMEDICAL LICENSE
2MD029977EOTHERPAMEDICAL LICENSE
341910OTHERCOMEDICAL LICENSE
466490OTHEROHMEDICAL LICENSE

General Provider Information

NPI Number : 1174559033
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID JAY SAND MD
Provider Business Mailing Address
First Line : 1685 COLUMBUS RD
Second Line :
City : GRANVILLE
State : OH
Zip : 43023-1231
Country : US
Telephone Number : 740-587-7093
Fax Number :
Provider Business Practice Location Address
First Line : 1685 COLUMBUS RD
Second Line :
City : GRANVILLE
State : OH
Zip : 43023-1231
Country : US
Telephone Number : 740-587-7093
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2006
Last Update Date : 07/08/2007

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Directions to “ DR. DAVID JAY SAND MD” Practice Location

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