Individual
MICHAEL D. SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1285 HEMBREE RD, SUITE 200A, ROSWELL, GA 30076-5720
(770) 475-2710
(770) 360-0498
Mailing address
1285 HEMBREE RD, SUITE 200A, ROSWELL, GA 30076-5720
(770) 475-2710
(770) 360-0498
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006454
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003125289A
—
GA
05
—
003125289C
—
GA
Enumeration date
06/12/2012
Last updated
01/25/2017
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