Provider Demographics
NPI:1548245228
Name:SANDERS, STEPHEN G (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:G
Last Name:SANDERS
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:2000A SOUTHBRIDGE PKWY
Mailing Address - Street 2:STE 300
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-7718
Mailing Address - Country:US
Mailing Address - Phone:205-871-4274
Mailing Address - Fax:205-871-4301
Practice Address - Street 1:42024 ALABAMA HWY 195
Practice Address - Street 2:
Practice Address - City:HALEYVILLE
Practice Address - State:AL
Practice Address - Zip Code:35565-7054
Practice Address - Country:US
Practice Address - Phone:205-486-2968
Practice Address - Fax:205-486-2962
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2015-12-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL000073042085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4302061OtherAETNA
AL511-15614OtherBLUE CROSS
AL105622Medicaid
ALP01042902OtherRRMC
ALP01042902OtherRRMC
AL4302061OtherAETNA