Individual
DR. SANDRA L STOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
330 N 8TH AVE E, DULUTH, MN 55805-2024
(218) 723-1112
Mailing address
330 N 8TH AVE E, DULUTH, MN 55805-2024
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
31998
MN
207Q00000X
Family Medicine Physician
Primary
31998
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
785090500
—
MN
01
—
80966ST
BLUE CROSS
MN
01
—
926741014026
PREFERRED
MN
Enumeration date
03/09/2006
Last updated
04/17/2020
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