Provider Demographics
NPI:1184686818
Name:COLWELL, SARAH O (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:O
Last Name:COLWELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1655 BEAM AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-1163
Mailing Address - Country:US
Mailing Address - Phone:651-232-7800
Mailing Address - Fax:651-232-7826
Practice Address - Street 1:1655 BEAM AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1163
Practice Address - Country:US
Practice Address - Phone:651-232-7800
Practice Address - Fax:651-232-7826
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MN23962208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA95411Medicare UPIN