Provider Demographics
NPI:1407825458
Name:SANDGREN, MARIA E (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:E
Last Name:SANDGREN
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 1:9813 HAWKS NEST DR
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-7827
Mailing Address - Country:US
Mailing Address - Phone:608-239-5885
Mailing Address - Fax:
Practice Address - Street 1:9813 HAWKS NEST DR
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-7827
Practice Address - Country:US
Practice Address - Phone:608-239-5885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI37039207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology