Individual
EDMUNDO DAVID SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
VA MEDICAL CENTER, 2459 W MAIN ST, MARION, IL 62959
(618) 997-5311
Mailing address
VA MEDICAL CENTER, 2459 W MAIN STREET, MARION, IL 62959
(618) 997-5311
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
03607312
IL
Other
Enumeration date
10/31/2006
Last updated
07/08/2007
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