Individual
DEAN S SANDQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1314 E WALNUT ST, WASHINGTON, IN 47501-2120
(812) 254-2760
(812) 254-8636
Mailing address
PO BOX 32, WASHINGTON, IN 47501-0032
(812) 254-2760
(812) 254-8636
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01033843
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000094093
ANTHEM
IN
05
—
200041720
—
IN
01
—
220018913
RAILROAD MEDICARE
IN
Enumeration date
05/17/2006
Last updated
05/07/2008
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