Provider Demographics
NPI:1740216787
Name:SANDERS, CYNTHIA M (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:SANDERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7905 CALUMET AVE
Mailing Address - Street 2:FRANCISCAN HAMMOND CLINIC LLC
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-1215
Mailing Address - Country:US
Mailing Address - Phone:219-836-7214
Mailing Address - Fax:219-836-0343
Practice Address - Street 1:7905 CALUMET AVE
Practice Address - Street 2:FRANCISCAN HAMMOND CLINIC LLC
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1215
Practice Address - Country:US
Practice Address - Phone:219-836-7214
Practice Address - Fax:219-836-0343
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01035201A207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100204400AMedicaid
IN473060SSMedicare ID - Type Unspecified
IN100204400AMedicaid
INE05554Medicare UPIN