Individual
DR. SANDRA J AHLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 MEDICAL DR, HANNIBAL, MO 63401-6877
(573) 231-3108
(573) 231-3721
Mailing address
100 MEDICAL DR, P.O. BOX 311, HANNIBAL, MO 63401-6877
(573) 231-3108
(573) 231-3721
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
R1C75
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201689700
—
MO
Enumeration date
01/11/2006
Last updated
02/14/2021
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