Individual
SCOTT K SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
3721 ROME DR, SUITE A, LAFAYETTE, IN 47905-4408
(765) 807-7100
(765) 807-7101
Mailing address
3721 ROME DR, SUITE A, LAFAYETTE, IN 47905-4408
(765) 807-7100
(765) 870-7101
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01045654
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000507081
ANTHEM
IN
01
—
10019219
ENCORE
IN
05
—
200375760
—
IN
Enumeration date
06/10/2005
Last updated
09/13/2011
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