Provider Demographics
NPI:1891953808
Name:OBERLANDER, SEAN GREGORY (SA)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:GREGORY
Last Name:OBERLANDER
Suffix:
Gender:M
Credentials:SA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100536
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80250-0536
Mailing Address - Country:US
Mailing Address - Phone:303-514-9190
Mailing Address - Fax:
Practice Address - Street 1:1914 S WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3323
Practice Address - Country:US
Practice Address - Phone:303-514-9190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical