Individual
REGINALD SANDY
Active
Individual
REGINALD SANDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
02001472
IN
207RG0100X
Gastroenterology Physician
TP598
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100427420A
—
IN
05
—
200002550
—
IN
01
—
IN3764001
MEDICARE
IN
Enumeration date
08/03/2005
Last updated
01/19/2022
Update your record
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