| Mark Sandefur, | |
|
1200 Grant Blvd W, Wabasha, MN 55981-1042 | |
| (608) 782-7300 | |
| Not Available |
| Full Name | Mark Sandefur |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 13 Years |
| Location | 1200 Grant Blvd W, Wabasha, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255674073 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 60108 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Park Nicollet Methodist Hospital | Saint louis park, MN | Hospital |
| Hutchinson Health | Hutchinson, MN | Hospital |
| North Memorial Health - Robbinsdale Hospital | Robbinsdale, MN | Hospital |
| Regions Hospital | Saint paul, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Saint Elizabeths Hospital Of Wabasha Inc | 5092619387 | 93 |
| Entity Name | Emergency Physicians Professional Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801871934 PECOS PAC ID: 9537072657 Enrollment ID: O20031106000068 |
| Entity Name | Saint Elizabeths Hospital of Wabasha Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659355600 PECOS PAC ID: 5092619387 Enrollment ID: O20031119000811 |
| Entity Name | Gundersen Lutheran Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376593442 PECOS PAC ID: 2163331414 Enrollment ID: O20130807000951 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Sandefur, 1836 South Ave, La Crosse, WI 54601-5429 Ph: (608) 782-7300 | Mark Sandefur, 1200 Grant Blvd W, Wabasha, MN 55981-1042 Ph: (608) 782-7300 |
Dr. Nicole Marie Wallis, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1200 Grant Blvd W, Wabasha, MN 55981 Phone: 651-565-4531 |