Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 01076379 | IN |
NPI | 1598874364 |
---|---|
Provider Name | Don B Sanders |
First Address | Indianapolis, IN 46206-1026 |
Second Address | Indianapolis, IN 46202-5109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 04/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201348770 | (05) | IN |