Provider Demographics
NPI:1336466820
Name:SANDERS, MIRICA ARTINE (DO)
Entity Type:Individual
Prefix:DR
First Name:MIRICA
Middle Name:ARTINE
Last Name:SANDERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6995 WOODLANDS LN
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-4664
Mailing Address - Country:US
Mailing Address - Phone:216-372-5261
Mailing Address - Fax:
Practice Address - Street 1:6995 WOODLANDS LN
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-4664
Practice Address - Country:US
Practice Address - Phone:216-577-3441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH00926962084P0800X
GA912242084P0800X
OH34-0109952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry