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Individual
SCOTT SANFORD
Active
Individual
SCOTT SANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D9646
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0065CK
BLUE CROSS BLUE SHIELD
TX
05
—
132029304
—
TX
Enumeration date
06/14/2005
Last updated
02/21/2014
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