Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 16452 | ND |
NPI | 1326497561 |
---|---|
Provider Name | Dr. Jared Sander |
First Address | Duluth, MN 55805-1951 |
Second Address | Fargo, ND 58103-6132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2016 |
Last Update Date | 03/09/2020 |