Individual
SANDRA J VICTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
148 W NORTH ST, SPRINGFIELD, OH 45504-2547
(937) 323-5001
Mailing address
148 W NORTH ST, SPRINGFIELD, OH 45504-2547
(937) 323-5001
(937) 323-5413
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
35076026V
OH
2085R0001X
Radiation Oncology Physician
Primary
35076026
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2143022
—
OH
Enumeration date
06/01/2005
Last updated
04/19/2021
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