Individual
DR. STEVEN A SANDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
210 WISCONSIN AMERICAN DR, FOND DU LAC, WI 54937-2999
(920) 907-7000
(920) 907-7110
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
54351-20
WI
2084P0800X
Psychiatry Physician
01065870A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01065870A
INDIANA PROFESSIONAL LICENSING AGENCY
IN
05
—
100052364
—
WI
01
—
54351-20
DEPT. OF SAFETY AND PROFESSIONAL SERVICES
WI
Enumeration date
09/04/2006
Last updated
04/25/2025
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