Individual
JONATHAN ROBERT SANDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
512 SKYLINE BLVD STE 1, CLOQUET, MN 55720-1199
(218) 879-4641
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
36412
MN
207RH0003X
Hematology & Oncology Physician
Primary
36412
MN
207RX0202X
Medical Oncology Physician
36412
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085525100
—
MN
05
—
32448000
—
WI
Enumeration date
07/09/2006
Last updated
07/02/2024
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