Individual
CHARLES W SANDERLIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3527 N VALDOSTA RD, VALDOSTA, GA 31602-1068
(229) 247-2290
(229) 244-2626
Mailing address
3527 N VALDOSTA RD, VALDOSTA, GA 31602-1068
(229) 247-2290
(229) 244-2626
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
051543
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00954445A
—
GA
05
—
265002900
—
FL
01
—
GRP1215
MEDICARE PTAN
GA
Enumeration date
06/08/2005
Last updated
03/23/2010
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