Provider Demographics
NPI:1538185285
Name:SANDA, RONALD MARTIN (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:MARTIN
Last Name:SANDA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR
Mailing Address - Street 2:PO BOX 0446 LOBBY J
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:4350 JACKSON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103
Practice Address - Country:US
Practice Address - Phone:734-761-2581
Practice Address - Fax:734-761-9540
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2018-07-19
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Provider Licenses
StateLicense IDTaxonomies
MI4301044980207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1595919Medicaid
B45862Medicare UPIN
MI0814234101Medicare ID - Type Unspecified