Provider Demographics
NPI:1881880862
Name:SANDERS, ANTHONY L D (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:L D
Last Name:SANDERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1400 N RITTER AVE
Practice Address - Street 2:SUITE 431
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-3050
Practice Address - Country:US
Practice Address - Phone:317-355-3090
Practice Address - Fax:317-355-3091
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01065666A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200949450Medicaid
INM400043106Medicare PIN
INM400052062Medicare PIN
IN200949450Medicaid
INM400052060Medicare PIN