Individual
MRS. THEODORA SADDORIS
Active
Individual
MRS. THEODORA SADDORIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01033704A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000086963
ANTHEM
—
01
—
003640
SIHO
—
Enumeration date
05/10/2006
Last updated
01/31/2008
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