Individual
TONY O SANDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
101 MANNING DR, CHAPEL HILL, NC 27514-4220
(919) 966-5136
Mailing address
101 MANNING DR, CHAPEL HILL, NC 27514-4220
(919) 966-5136
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
RN126117
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
5833
NC
367500000X
Certified Registered Nurse Anesthetist
5845
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K400170079
MEDICARE PTAN
WI
01
—
K400174628
MEDICARE PTAN
WI
Enumeration date
09/22/2005
Last updated
03/18/2025
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