MEDICARE: DR. BRAD S SANDLER DO

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	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	IN02001668A	IN

General Provider Information

NPI Number	:	1710981360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRAD S SANDLER DO

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	10/20/2022

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