MEDICARE: ALICIA N. SANDERS, MD LLC

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
1	207P00000X	Emergency Medicine Physician

General Provider Information

NPI Number	:	1558879544
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALICIA N. SANDERS, MD LLC

Provider Business Mailing Address
First Line	:	6605 ROTHCHILD BLVD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-1769
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9460 E 146TH ST
Second Line	:
City	:	NOBLESVILLE
State	:	IN
Zip	:	46060-4966
Country	:	US
Telephone Number	:	317-703-1999
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	ALICIA SANDERS
Credential	:	MD
Telephone Number	:	317-460-2673

Provider Enumeration Date	:	01/12/2018
Last Update Date	:	01/12/2018

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