| Doctor Name: | DR. DAVID GREGORY SANDERSON |
| NPI Number: | 1942207642 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.P.M. |
| License Number: | SC004253L |
| Business Practice Address: | 238 Chestnut St St Marys, PA - 158571708 |
| Business Phone Number: | 8148347240 |
| Business Fax Number: | 8147816581 |
| Mailing Address: | 238 Chestnut St, ST MARYS |
| State: | PA |
| Postal Code: | 158571708 |
| Phone Number: | 8148347240 |
| Fax Number: | 8147816581 |
| NPI Enumeration Date: | 07/07/2005 |
| NPI Last Update Date: | 06/19/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | SC004253L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |