Individual
JOHN SANDEFUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 EAST MEDICAL CENTER DRIVE, ANN ARBOR, MI 48109-5256
(734) 936-4000
Mailing address
700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704253952
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/18/2014
Last updated
08/31/2015
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