Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 35078507 | OH |
N | 208000000X | Pediatrician | MD19982 | ME |
N | 2080P0207X | Pediatric Hematology-Oncologist | 24713 | AL |
N | 2080P0207X | Pediatric Hematology-Oncologist | MD037750 | DC |
NPI | 1063516656 |
---|---|
Provider Name | Jane E Sande |
First Address | Van Wert, OH 45891-2496 |
Second Address | Van Wert, OH 45891-2496 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2006 |
Last Update Date | 10/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009995210 | (05) | AL |
009995220 | (05) | AL |
36986 | (02) |