Provider Demographics
NPI:1689606683
Name:SAND, STEPHEN PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:PAUL
Last Name:SAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:825 WASHINGTON ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3448
Mailing Address - Country:US
Mailing Address - Phone:781-769-9830
Mailing Address - Fax:781-769-6981
Practice Address - Street 1:825 WASHINGTON ST
Practice Address - Street 2:SUITE 150
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3441
Practice Address - Country:US
Practice Address - Phone:781-769-9830
Practice Address - Fax:781-769-6981
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2008-06-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MAAS1092256207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB73535Medicare UPIN
MAC18120Medicare ID - Type Unspecified