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Individual

DR. KELLY DAWN SANDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
14000 FAIRVIEW DR, BURNSVILLE, MN 55337-5713
(952) 993-8700
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
55446
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
55446
MEDICAL LISCENSE
MN
Enumeration date
04/27/2011
Last updated
03/18/2021
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