| Organization Name: | DAVID G. SANDERSON, DPM, PC |
| NPI Number: | 1093094088 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID G. SANDERSON (OWNER) |
| Mailing Address: | 238 Chestnut St Saint Marys |
| State: | PA US |
| Postal Code: | 158572304 |
| Phone Number: | 8148347240 |
| Fax Number: | 8147816581 |
| NPI Enumeration Date: | 08/09/2011 |
| NPI Last Update Date: | 08/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP1100X |
| License Number: | SC004253L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Podiatric |
| Taxonomy Definition: | |