Maxwell Louis Sandberg, MD, MS

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

390200000X Issued in NC

Practice address

Wake Forest School of Medicine Medical Center Boulevard
Winston Salem, NC 27157-0001

Phone

(336) 716-9601

NPI assigned

Mar 21, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1952003923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "994 W 2ND ST UNIT 386",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013899",
            "telephone_number": "248-904-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WAKE FOREST SCHOOL OF MEDICINE MEDICAL CENTER BOULEVARD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDBERG",
        "first_name": "MAXWELL",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "390200000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Sanchez
• Wendy L Sanchezruiz, PHARMD
• James R Sancrant Jr., DO
• Sanctuary Counseling & Wellness
• Steven Edward Sand
• Zachary W Sandbulte, MD
• James L Sanderford Jr., MD
• Catherine Elizabeth Sanders, FNP-C
• Jimmy Sanders
• John W. Sanders III, M.D.

• Urology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Urology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.