Individual
SANDRA L DEAUSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8865 W 400 N STE 165, MICHIGAN CITY, IN 46360-9010
(219) 877-3333
(219) 878-9644
Mailing address
1040 SIERRA DR STE 400, GREENWOOD, IN 46143-7241
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01044430
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200093050
—
IN
Enumeration date
08/02/2006
Last updated
03/13/2021
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