Individual
TIMOTHY A. SANBORN
Active
Individual
TIMOTHY A. SANBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036102493
IL
207RC0000X
Cardiovascular Disease Physician
Primary
69326
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073600987
—
WI
Enumeration date
10/10/2006
Last updated
07/25/2018
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