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Individual

DR. RUSSELL WAYNE SAWYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
246 PERKINS ST, SONOMA, CA 95476-6954
(707) 938-7690
(844) 581-1700
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(707) 541-7900
(707) 573-5412

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
511294
CA
2086S0129X
Vascular Surgery Physician
G66227
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
101036100
FIRSTCARE
01
85507539
MEDICAID
NM
01
G66227
STATE MEDICAL LICENSE
CA
Enumeration date
07/03/2006
Last updated
08/27/2019
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