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Individual

DR. SANDRA K SURBRUGG

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
123 WESTERN HILLS BLVD, CHEYENNE, WY 82009-3446
(307) 635-0226
(307) 635-1924
Mailing address
123 WESTERN HILLS BLVD, CHEYENNE, WY 82009-3446
(307) 635-0226
(307) 635-1924

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
3492A
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
83025288113
NE
Enumeration date
03/07/2006
Last updated
07/08/2007
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