Provider Demographics
NPI:1861717316
Name:SANDERS, SARAH KATHLEEN (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:KATHLEEN
Last Name:SANDERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:K
Other - Last Name:COLVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14077 QUARTER HORSE CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-7091
Mailing Address - Country:US
Mailing Address - Phone:317-370-3200
Mailing Address - Fax:
Practice Address - Street 1:2001 W 86TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1902
Practice Address - Country:US
Practice Address - Phone:317-338-2281
Practice Address - Fax:317-338-6359
Is Sole Proprietor?:No
Enumeration Date:2010-03-27
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01073836A207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN264430231OtherMEDICARE PTAN
IN201095480Medicaid