Provider Demographics
NPI:1417201047
Name:LAPHAM, SANDRA CHERYL (MD, MPH, FASAM)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:CHERYL
Last Name:LAPHAM
Suffix:
Gender:F
Credentials:MD, MPH, FASAM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 ENCINO PL NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2602
Mailing Address - Country:US
Mailing Address - Phone:505-244-3099
Mailing Address - Fax:188-877-7480
Practice Address - Street 1:612 ENCINO PL NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2602
Practice Address - Country:US
Practice Address - Phone:505-244-3099
Practice Address - Fax:188-877-7480
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM81-249207R00000X, 207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine