Provider Demographics
NPI:1417156332
Name:SANDAIRE, BENS JEAN-GERALD (DO)
Entity Type:Individual
Prefix:DR
First Name:BENS
Middle Name:JEAN-GERALD
Last Name:SANDAIRE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:281 NANTUCKET DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-3346
Mailing Address - Country:US
Mailing Address - Phone:313-574-8579
Mailing Address - Fax:313-574-8579
Practice Address - Street 1:570 CLINTON ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-2334
Practice Address - Country:US
Practice Address - Phone:313-574-8579
Practice Address - Fax:313-574-8579
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI51010119312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry