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NPI Code Detail

MEDICARE: DR. ANDREW SEDIVY MD

MEDICARE: DR. ANDREW SEDIVY 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
1207L00000XAnesthesiology Physician56718MN

General Provider Information

NPI Number : 1386633576
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW SEDIVY MD
Provider Business Mailing Address
First Line : 14700 28TH AVE N STE 20
Second Line :
City : PLYMOUTH
State : MN
Zip : 55447-4876
Country : US
Telephone Number : 763-852-0435
Fax Number :
Provider Business Practice Location Address
First Line : 14700 28TH AVE N STE 20
Second Line :
City : PLYMOUTH
State : MN
Zip : 55447-4876
Country : US
Telephone Number : 763-852-0435
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2005
Last Update Date : 09/11/2013

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Directions to “ DR. ANDREW SEDIVY MD” Practice Location

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