Provider Demographics
NPI:1760443873
Name:KIMMER, SANDRA LEE (MD)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LEE
Last Name:KIMMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9300 DEWITT LOOP
Mailing Address - Street 2:
Mailing Address - City:FORT BELVOIR
Mailing Address - State:VA
Mailing Address - Zip Code:22060-5285
Mailing Address - Country:US
Mailing Address - Phone:571-231-1803
Mailing Address - Fax:571-231-6617
Practice Address - Street 1:9300 DEWITT LOOP
Practice Address - Street 2:
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-5285
Practice Address - Country:US
Practice Address - Phone:571-231-1803
Practice Address - Fax:571-231-6617
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2023-10-20
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Provider Licenses
StateLicense IDTaxonomies
MN43529207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine