MEDICARE: DR. SARA MARIE LOKSTAD 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	207Q00000X	Family Medicine Physician	52823	MN

General Provider Information

NPI Number	:	1962464230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARA MARIE LOKSTAD M.D.

Provider Business Mailing Address
First Line	:	400 EAST THIRD STREET
Second Line	:	ESSENTIA HEALTH DULUTH CLINIC MCL2CRED
City	:	DULUTH
State	:	MN
Zip	:	55805-1951
Country	:	US
Telephone Number	:	218-693-1010
Fax Number	:

Provider Business Practice Location Address
First Line	:	35205 COUNTY ROAD 3
Second Line	:
City	:	CROSSLAKE
State	:	MN
Zip	:	56442-4057
Country	:	US
Telephone Number	:	218-692-1010
Fax Number	:

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

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	03/19/2018

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