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NPI Code Detail

MEDICARE: SPINE & ORTHOPEDIC MEDICINE, INC

MEDICARE: SPINE & ORTHOPEDIC MEDICINE, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208VP0014XInterventional Pain Medicine PhysicianIN02001668AIN
2208VP0014XInterventional Pain Medicine Physician
3204D00000XNeuromusculoskeletal Medicine & OMM PhysicianIN02001668A

General Provider Information

NPI Number : 1427284983
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPINE & ORTHOPEDIC MEDICINE, INC
Provider Business Mailing Address
First Line : 51050 BITTERSWEET RD
Second Line : SUITE B
City : GRANGER
State : IN
Zip : 46530-7879
Country : US
Telephone Number : 574-255-7246
Fax Number : 574-243-9060
Provider Business Practice Location Address
First Line : 51050 BITTERSWEET RD
Second Line : SUITE B
City : GRANGER
State : IN
Zip : 46530-7879
Country : US
Telephone Number : 574-255-7246
Fax Number : 574-243-9060
Authorized Official
Title or Position : PHYSICIAN/OWNER
Name : BRAD S SANDLER
Credential : D
Telephone Number : 574-255-7246
Provider Enumeration Date : 06/10/2009
Last Update Date : 10/13/2022

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Directions to “SPINE & ORTHOPEDIC MEDICINE, INC ” Practice Location

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