Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 33427 | WI |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 33427 | WI |
N | 2086S0105X | Surgery of the Hand | 98-01476 | NC |
NPI | 1669565156 |
---|---|
Provider Name | Steven Byron Sanford |
First Address | Marshfield, WI 54449-5703 |
Second Address | Marshfield, WI 54449-5703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 22/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1150V | BLUE CROSS BLUE SHIELD NC (01) | NC |
5600659 | AETNA (01) | |
6466170 | CIGNA (01) | |
891105V | (05) | NC |
F60102 | (02) |