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Individual

SANDY BOTROS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7910 E WASHINGTON ST STE 200, INDIANAPOLIS, IN 46219-5563
(317) 355-7171
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-9312
(317) 621-6920

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01079930A
IN
207Q00000X
Family Medicine Physician
125066142
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300015259
IN
Enumeration date
07/14/2015
Last updated
01/05/2026
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