Provider Demographics
NPI:1316141138
Name:SANDBERG, ALISON LEIGH (MD)
Entity type:Individual
Prefix:DR
First Name:ALISON
Middle Name:LEIGH
Last Name:SANDBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10350 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10350 E DAKOTA AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-1314
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO462732085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ483447Medicaid
CO021600OtherKAISER COMMERCIAL NUMBER
NE10025709000Medicaid
OK200238430AMedicaid
TX2044414-01Medicaid
WY1316141138Medicaid
KS200602130AMedicaid
NM89731361Medicaid
MT1316141138Medicaid
NE84059792913Medicaid
CO86870564Medicaid
NE10025709000Medicaid
NENA1215030Medicare PIN
COCO304433Medicare PIN
CO86870564Medicaid
WY1316141138Medicaid
NE84059792913Medicaid
COCO300883Medicare PIN
TX2044414-01Medicaid
NEP00796313Medicare PIN
COP00643722Medicare PIN