Provider Demographics
NPI:1275648826
Name:LANDER, SARA A (MD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:A
Last Name:LANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 SAINT LUKES CENTER DR
Mailing Address - Street 2:SUITE 504
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3509
Mailing Address - Country:US
Mailing Address - Phone:314-205-6399
Mailing Address - Fax:314-523-2798
Practice Address - Street 1:121 SAINT LUKES CENTER DR
Practice Address - Street 2:SUITE 504
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3509
Practice Address - Country:US
Practice Address - Phone:314-205-6399
Practice Address - Fax:314-523-2798
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003013348207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
841682728OtherTAX ID
MO209252634Medicaid
P00215290OtherRR MEDICARE
P00215290OtherRR MEDICARE
005014694Medicare PIN
MO005014694Medicare ID - Type Unspecified