Individual
MATTHEW F SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1233 34TH ST NW, BEMIDJI, MN 56601-5112
(218) 333-5283
Mailing address
1233 34TH ST NW, BEMIDJI, MN 56601-5112
(218) 333-5283
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
49607
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
368279000
—
MN
Enumeration date
05/05/2006
Last updated
08/06/2012
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