Individual
MICHAEL WILLIAM SANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
720 ESKENAZI AVE, INDIANAPOLIS, IN 46202-5187
(317) 880-9472
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01063951A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000651110
ANTHEM PTAN
IN
Enumeration date
07/14/2008
Last updated
12/02/2024
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