Individual
DR. LORI JACQUEMIN SANFORD
Active
Individual
DR. LORI JACQUEMIN SANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
01072559A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201100610A
—
IN
01
—
IN2966001
MEDICARE
IN
Enumeration date
05/14/2009
Last updated
04/20/2017
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