Individual
MARK D SANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7766 EWING BLVD, SUITE L, FLORENCE, KY 41042-1815
(859) 371-1153
(859) 647-5113
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 371-1153
(859) 647-5113
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24807
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080095899
RAILROAD MEDICARE
KY
05
—
2809367
—
OH
05
—
64248073
—
KY
01
—
P00847799
RAILROAD MEDICARE
KY
Enumeration date
06/27/2006
Last updated
09/11/2018
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