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Individual
DR. JAY I SANDLOW
Active
Individual
DR. JAY I SANDLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
45676
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005806261P
HUMANA
—
05
—
1063465797
—
WI
Enumeration date
05/17/2006
Last updated
09/10/2014
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