Provider Demographics
NPI:1922200013
Name:SANDERS, ALICIA NICHOLE PERRY (MD)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:NICHOLE PERRY
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 1:6605 ROTHCHILD BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46278-1769
Mailing Address - Country:US
Mailing Address - Phone:317-329-5011
Mailing Address - Fax:
Practice Address - Street 1:6333 S EAST ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-7107
Practice Address - Country:US
Practice Address - Phone:317-783-7474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01065794A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine