Provider Demographics
NPI:1538115316
Name:SANDBERG, BETSY B (MD)
Entity Type:Individual
Prefix:DR
First Name:BETSY
Middle Name:B
Last Name:SANDBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 DURHAM POINT RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03824-3100
Mailing Address - Country:US
Mailing Address - Phone:603-868-5211
Mailing Address - Fax:
Practice Address - Street 1:57 HIGHLAND AVE
Practice Address - Street 2:PEDIATRIC ER
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2141
Practice Address - Country:US
Practice Address - Phone:978-354-2750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213816208000000X
NH11666208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3102733Medicaid
MAA34230Medicare ID - Type Unspecified