Provider Demographics
NPI:1710981360
Name:SANDLER, BRAD S (DO)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:S
Last Name:SANDLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:51050 BITTERSWEET RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-7879
Mailing Address - Country:US
Mailing Address - Phone:574-255-7246
Mailing Address - Fax:574-243-9060
Practice Address - Street 1:51050 BITTERSWEET RD
Practice Address - Street 2:SUITE B
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530-7879
Practice Address - Country:US
Practice Address - Phone:574-255-7246
Practice Address - Fax:574-243-9060
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2022-10-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ININ02001668A204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN262690AMedicare PIN
ING16169Medicare UPIN