Individual
JEFFREY SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1185 TOWN CENTRE DR #205, EAGAN, MN 55123-1343
(612) 871-1145
(612) 870-5491
Mailing address
PO BOX 14909, MINNEAPOLIS, MN 55414-0909
(612) 871-1145
(612) 870-5491
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
12345
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57468
MN LICENSE
MN
Enumeration date
05/12/2008
Last updated
07/21/2016
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