Individual
KENTON SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1414 PHYSICIANS DR, WILMINGTON, NC 28401-7335
(910) 796-7900
Mailing address
1414 PHYSICIANS DR, WILMINGTON, NC 28401-7335
(910) 796-7900
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
2004-00256
NC
207R00000X
Internal Medicine Physician
200400256
NC
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
200400256
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13632
BC/BS OF NC
NC
05
—
8913632
—
NC
Enumeration date
08/31/2005
Last updated
01/13/2016
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