Doctor Name: | TERESA SANDERS |
NPI Number: | 1407246135 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 50.004282 |
Business Practice Address: | 6780 Mayfield Rd Mayfield Heights, OH - 441242203 |
Business Phone Number: | 4403121345 |
Business Fax Number: | |
Mailing Address: | 6780 Mayfield Rd, MAYFIELD HEIGHTS |
State: | OH |
Postal Code: | 441242203 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/03/2015 |
NPI Last Update Date: | 03/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 50.004282 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |