DR. STEVEN A SANDSTROM (NPI# 1174625610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174625610 |
| Entity Type | Individual |
| Full Name | DR. STEVEN A SANDSTROM |
| Credential | M.D. |
| Practice Address |
210 Wisconsin American Dr Fond Du Lac WI 54937-2999 |
| Mailing Address |
Po Box 1243 Fond Du Lac WI 54936-1243 |
| Practice Telephone | 9209077000 |
| Practice Fax Number | 9209077110 |
| Mailing Telephone | 9209077000 |
| Mailing Fax Number | 9209077110 |
| Enumeration Date | 2006-09-04 |
| Last Update Date | 2017-02-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
54351-20 | WI | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
01065870A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | DEPT. OF SAFETY AND PROFESSIONAL SERVICES | 54351-20 | 01 |
| IN | INDIANA PROFESSIONAL LICENSING AGENCY | 01065870A | 01 |
| Street Address |
210 WISCONSIN AMERICAN DR |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54937-2999 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750374096 | James A Avery | Specialist | 210 Wisconsin American Dr, Suite #265, Fond Du Lac, WI 54935-2999 | 2005-08-23 |
| 1326609306 | Alicia Birschbach | Physical Therapy Assistant | 210 Wisconsin American Dr, Fond Du Lac, WI 54937-2999 | 2019-06-21 |
| 1437673217 | Marina Dewhurst | Physical Therapist | 210 Wisconsin American Dr, Fond Du Lac, WI 54937-2999 | 2017-08-02 |
| 1255855045 | Holly J Weiland | Physical Medicine & Rehabilitation | 210 Wisconsin American Dr, Fond Du Lac, WI 54937-2999 | 2017-08-02 |
| 1528519758 | Betty Xiong | Physician Assistant | 210 Wisconsin American Dr, Fond Du Lac, WI 54937 | 2016-10-24 |
| 1578014817 | Carolyn V Essmann | Social Worker | 210 Wisconsin American Dr, Fond Du Lac, WI 54937-2999 | 2016-10-21 |
| 1598112963 | Jennifer M Halbach | Nurse Practitioner | 210 Wisconsin American Dr, Fond Du Lac, WI 54937 | 2016-05-16 |
| 1356725543 | Jolene K Oehlke | Nurse Practitioner | 210 Wisconsin American Dr, Fond Du Lac, WI 54937-2999 | 2015-07-17 |
| 1093104887 | Adam P Whittington | Dermatology | 210 Wisconsin American Dr, Fond Du Lac, WI 54937-2999 | 2015-01-15 |
| 1548667231 | Tanya Watry | Physician Assistant | 210 Wisconsin American Dr, Fond Du Lac, WI 54937 | 2014-11-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710523774 | Lisa Diane Brown | Social Worker | W3950 Wi-23 Trunk, Fond Du Lac, WI 54937 | 2019-11-25 |
| 1538700083 | Kristine Karpen | Technician | 1812 Thurke Ave, North Fond Du Lac, WI 54937 | 2019-10-07 |
| 1962719245 | James Hugh Rupple | Ophthalmology | W4410 Mary Hill Park, Fond Du Lac, WI 54937 | 2010-09-08 |
| 1467591131 | Rosonna Sue Comers | Social Worker | N6687 Wrightway Dr, Ste D, Fond Du Lac, WI 54937 | 2007-02-06 |
| 1487731741 | Daniel James Kierstead | Optometrist | 377 N Rollings Meadows Dr, Fond Du Lac, WI 54937 | 2006-11-01 |
| 1578813606 | Joline Brotzman | Nurse Practitioner | 700 Park Ridge Ln, North Fond Du Lac, WI 54937 | 2012-09-17 |
| 1306085998 | Forefront Dermatology, S.c. | Dermatology | 111 Wisconsin American Dr, Fond Du Lac, WI 54937 | 2009-02-05 |
| 1073665527 | Optivision Eye Care LLP | Eyewear Supplier (Equipment, not the service) | 437 N Pioneer Rd, Fond Du Lac, WI 54937 | 2007-01-17 |
| 1588771778 | Julie A Sheehan | Family Medicine | 700 Park Ridge Ln, North Fond Du Lac, WI 54937 | 2006-08-24 |
| 1134777352 | Releve Physical Therapy LLC | Physical Therapist | 1909 Chapman Ave, N Fond Du Lac, WI 54937-1023 | 2019-08-30 |
| Find all providers in zip 54937 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538594783 | Lakeside Neurocare | Psychiatry & Neurology | 210 Wisconsin American Dr, Fond Du Lac, WI 54937-2999 | 2013-09-06 |
| 1225220254 | Lakeside Neurocare Limited. | Psychiatry & Neurology | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2007-08-14 |
| 1811935752 | Xian Feng Gu | Psychiatry & Neurology | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689162661 | Tseun Han James Kong | Psychiatry & Neurology | Uw Hospitals and Clinics, 600 Highland Ave, Madison, WI 53792 | 2018-04-25 |
| 1235630625 | The Cervical Spine Institute and Neuromonitoring, LLC | Psychiatry & Neurology | 2221 S Webster Ave # 268, Green Bay, WI 54301-2158 | 2018-02-22 |
| 1235647793 | Midwest Monitoring, LLC | Psychiatry & Neurology | 4321 W College Ave Ste 200, Appleton, WI 54914 | 2018-01-18 |
| 1477937274 | Baycare Clinic LLP | Psychiatry & Neurology | 4801 Expo Drive, Manitowoc, WI 54220 | 2015-07-13 |
| 1184011975 | Abdulrahim Ismail | Psychiatry & Neurology | 3003 University Dr Ste 203, Marinette, WI 54143-4110 | 2015-04-20 |
| 1033505821 | Heydi Flores Podadera | Psychiatry & Neurology | 721 N Midvale Blvd, Madison, WI 53705-3233 | 2015-04-08 |
| 1104221092 | Sharon Anne Bremer | Psychiatry & Neurology | 423 Landimore Ln, Wales, WI 53183-9552 | 2014-11-04 |
| 1891120093 | Robert T Schmidt Jr. | Psychiatry & Neurology | 2460 Old Plank Rd, De Pere, WI 54115-8658 | 2013-09-06 |
| 1356656771 | Klasinski Neurocare, Sc | Psychiatry & Neurology | 500 Vincent St Ste B, Stevens Point, WI 54481-1842 | 2010-08-10 |
| 1497931661 | Audrey Jantzen | Psychiatry & Neurology | 1685 Highland Ave, Department of Neurology - Centennial Building, Madison, WI 53705-2281 | 2008-01-17 |
| Find all providers with the same taxonomy | ||||
| City | FOND DU LAC |
| Zip Code | 54937 |
Please comment or provide details below to improve the information on DR. STEVEN A SANDSTROM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.