Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 11948 | HI |
N | 208000000X | Pediatrician | 42313 | TN |
N | 208000000X | Pediatrician | 7726 | SD |
Y | 2080P0210X | Pediatric Nephrologist | 11841 | ND |
N | 2080P0210X | Pediatric Nephrologist | 7726 | SD |
NPI | 1164505608 |
---|---|
Provider Name | Dr. John T Sanders |
First Address | Sioux Falls, SD 57117-5074 |
Second Address | Sioux Falls, SD 57105-1521 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 26/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
17692 | (05) | ND |