Provider Demographics
NPI:1467417915
Name:MINTER-SAUER, ALICE E (MD)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:E
Last Name:MINTER-SAUER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:9880 ANGIES WAY STE 420
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2850
Practice Address - Country:US
Practice Address - Phone:502-394-6200
Practice Address - Fax:502-394-6210
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY24903207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
9004205OtherCIGNA / NMA
041701OtherSIHO / NMA
KY64249030Medicaid
000000350625OtherANTHEM / NMA
000052154MOtherHUMANA / NMA
KYP00181559OtherRAILROAD MEDICARE
1184164OtherCHA / NMA
2445722000OtherPASPORT ADVANTAGE / NMA
50004357OtherPASSPORT / NMA
50004357OtherPASSPORT / NMA
F26042Medicare UPIN