Individual
MR. PATRICK B SANDIFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12255 DE PAUL DR STE 500, BRIDGETON, MO 63044-2515
(314) 209-5180
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MDR3K84
MO
207RP1001X
Pulmonary Disease Physician
Primary
MDR3K84
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206930919
—
MO
Enumeration date
05/03/2006
Last updated
11/20/2020
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