Provider Demographics
NPI:1386088391
Name:SANDOVAL, ANDREA (MD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:SANDOVAL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:800 BRADBURY DR SE STE 116
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4310
Mailing Address - Country:US
Mailing Address - Phone:505-272-1476
Mailing Address - Fax:505-272-4628
Practice Address - Street 1:INTERNAL MEDICINE MSC10 5550
Practice Address - Street 2:1 UNIVERSITY OF NEW MEXICO
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-6331
Practice Address - Fax:505-272-4628
Is Sole Proprietor?:No
Enumeration Date:2013-04-20
Last Update Date:2024-10-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2017-0189207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology