Active NPI
Ben M Sanders Jr., CSA
- Surgical Assistant
- Glen Burnie, MD
National Provider Identifier
1780972398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 3469
- Practice address
- 305 Alexis Dr
Glen Burnie, MD 21061-6173 - Phone
- (443) 790-9439
- NPI assigned
- Jul 16, 2011
- Last updated
- Jul 16, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 3469 | MD | Primary |
Addresses
Primary practice location
305 Alexis Dr
Glen Burnie, MD 21061-6173
Mailing address
305 Alexis Dr
Glen Burnie, MD 21061-6173
Phone (443) 790-9439
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3469 | MD | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310774400000",
"number": "1780972398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 ALEXIS DR",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "210616173",
"telephone_number": "443-790-9439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 ALEXIS DR",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "210616173",
"telephone_number": "443-790-9439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERS",
"first_name": "BEN",
"middle_name": "M",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "CSA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-07-16",
"last_updated": "2011-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "MD",
"license": "3469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Burnie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.