Provider Demographics
NPI:1376895516
Name:SYFERT, SANDRA M (MD)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:M
Last Name:SYFERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:M
Other - Last Name:STEGMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 KIRTS BLVD
Mailing Address - Street 2:MEDICAL AFFAIRS
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4134
Mailing Address - Country:US
Mailing Address - Phone:248-824-6000
Mailing Address - Fax:
Practice Address - Street 1:4623 WESLEY AVE
Practice Address - Street 2:SUITE P
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-2246
Practice Address - Country:US
Practice Address - Phone:513-947-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.078953207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine