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Individual

GEORGE L SANDERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
516 E. NIZHONI BLVD., BOX 1337, GALLUP, NM 87301-1337
(505) 722-1000
(505) 726-8557
Mailing address
516 E. NIZHONI BLVD., BOX 1337, GALLUP, NM 87301-1337
(505) 722-1000
(505) 726-8557

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME16455
FL
207RC0000X
Cardiovascular Disease Physician
ME16455
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
776734
AZ
05
87357712
NM
Enumeration date
07/05/2006
Last updated
04/11/2008
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