Provider Demographics
NPI:1134214455
Name:SAUER, LOIE GOLDFIELD (MD)
Entity type:Individual
Prefix:
First Name:LOIE
Middle Name:GOLDFIELD
Last Name:SAUER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LOIE
Other - Middle Name:ANN
Other - Last Name:SAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:P.O. BOX 107
Mailing Address - Street 2:
Mailing Address - City:GRATON
Mailing Address - State:CA
Mailing Address - Zip Code:95444
Mailing Address - Country:US
Mailing Address - Phone:707-484-6090
Mailing Address - Fax:888-975-5732
Practice Address - Street 1:10750 GRATON RD
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-9738
Practice Address - Country:US
Practice Address - Phone:707-484-6090
Practice Address - Fax:888-975-5732
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG51463208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G514630Medicaid
E25332Medicare UPIN
00G514631Medicare ID - Type Unspecified