Provider Demographics
NPI:1811516651
Name:SANDERFIELD, TAMARA (MD, MBA, BA)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:
Last Name:SANDERFIELD
Suffix:
Gender:F
Credentials:MD, MBA, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4206 PACKARD ST APT 2
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1525
Mailing Address - Country:US
Mailing Address - Phone:734-510-9972
Mailing Address - Fax:
Practice Address - Street 1:4206 PACKARD ST APT 2
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-1525
Practice Address - Country:US
Practice Address - Phone:734-510-9972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-12
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI070480022084B0040X, 2084A0401X, 2085R0001X
101YA0400X, 101YM0800X, 101YP2500X, 103T00000X, 103TA0400X, 103TP0016X, 171000000X, 1710I1002X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & Neuropsychiatry
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
No171000000XOther Service ProvidersMilitary Health Care Provider
No1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program