Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 5901000553 | MI |
N | 222Z00000X | Podiatrist | 5901000553 | MI |
Y | 213EP1101X | Primary Podiatric Medicine | 0245 | AZ |
NPI | 1386611002 |
---|---|
Provider Name | Sanford Ralph Kaner |
First Address | Surprise, AZ 85374-7280 |
Second Address | Surprise, AZ 85374-7280 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2006 |
Last Update Date | 15/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1124460 | (05) | MI |
4383238 | AETNA US HEALTHCARE (01) | |
5635270 | BLUE CROSS BLUE SHIELD (01) | MI |
U20248 | (02) | MI |