Provider Demographics
NPI:1386834521
Name:LOTSTEIN, SANDRA (DO)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:LOTSTEIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 5TH ST.
Mailing Address - Street 2:STE 102
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501
Mailing Address - Country:US
Mailing Address - Phone:208-746-2810
Mailing Address - Fax:208-746-2810
Practice Address - Street 1:324 5TH ST
Practice Address - Street 2:STE 102
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-2408
Practice Address - Country:US
Practice Address - Phone:208-746-2810
Practice Address - Fax:208-746-2810
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDO-115207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine