Provider Demographics
NPI:1508874512
Name:SANDERS, STEVEN MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:MICHAEL
Last Name:SANDERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 GOODYEAR AVENUE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903
Mailing Address - Country:US
Mailing Address - Phone:256-792-8250
Mailing Address - Fax:256-792-8271
Practice Address - Street 1:1026 GOODYEAR AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903
Practice Address - Country:US
Practice Address - Phone:256-792-8250
Practice Address - Fax:256-792-8271
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14749207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051502421OtherBCBS OF ALA
AL009957890Medicaid
AL051502421OtherBCBS OF ALA
E14410Medicare UPIN