Individual
MRS. MARY SUSAN SANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.N.P.
Contact information
Practice address
2726 FULTON DR NW, CANTON, OH 44718-3506
(330) 455-5011
(330) 588-7127
Mailing address
2726 FULTON DR NW, CANTON, OH 44718-3506
(330) 455-5011
(330) 588-7127
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP-05340
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000492313
ANTHEM
OH
01
—
1073503322
HOMETOWN
OH
05
—
2179664
—
OH
01
—
341773267G
AULTCARE
OH
01
—
P00341076
MEDICARE RAILROAD
OH
Enumeration date
10/27/2005
Last updated
05/12/2020
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