Provider Demographics
NPI:1417940255
Name:SANGSTER, MICHAEL G (MD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:G
Last Name:SANGSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2524 CRESTWOOD RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-7623
Mailing Address - Country:US
Mailing Address - Phone:501-791-7546
Mailing Address - Fax:501-753-1992
Practice Address - Street 1:2524 CRESTWOOD RD
Practice Address - Street 2:SUITE 3
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-7623
Practice Address - Country:US
Practice Address - Phone:501-791-7546
Practice Address - Fax:501-753-1992
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC8303207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR132088002Medicaid
AR070009090OtherRR MC
AR5594317OtherAETNA
AR132088002Medicaid
F63237Medicare UPIN