Provider Demographics
NPI:1841371721
Name:SANDERS, RICHARD J (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:SANDERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 E 19TH AVE
Mailing Address - Street 2:SUITE 510
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1251
Mailing Address - Country:US
Mailing Address - Phone:303-388-6461
Mailing Address - Fax:303-863-0497
Practice Address - Street 1:1721 E 19TH AVE
Practice Address - Street 2:SUITE 510
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1251
Practice Address - Country:US
Practice Address - Phone:303-388-6461
Practice Address - Fax:303-863-0497
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13787208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC6918Medicare PIN
COD28120Medicare UPIN