MEDICARE: ANTHONY D SANDERS MD

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	207Y00000X	Otolaryngology Physician	01034467A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689671885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY D SANDERS MD

Provider Business Mailing Address
First Line	:	1655 N GLADSTONE AVE
Second Line	:	STE E
City	:	COLUMBUS
State	:	IN
Zip	:	47201-5380
Country	:	US
Telephone Number	:	812-376-3071
Fax Number	:	812-378-5721

Provider Business Practice Location Address
First Line	:	1655 N GLADSTONE AVE
Second Line	:	STE E
City	:	COLUMBUS
State	:	IN
Zip	:	47201-5380
Country	:	US
Telephone Number	:	812-376-3071
Fax Number	:	812-378-5721

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	02/09/2010

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