Individual
MR. EDWARD MOLTON SANDERS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1900 EXETER RD, SUITE 210, GERMANTOWN, TN 38138-2954
(901) 818-2183
(901) 682-9522
Mailing address
1900 EXETER RD, SUITE 210, GERMANTOWN, TN 38138-2954
(901) 818-2183
(901) 682-9522
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN0000131203
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN 14189
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00079839
—
MS
05
—
1514315
—
TN
01
—
1629219720
CHAMPUS/HUMANA TRICARE
—
01
—
4223156
BLUE CROSS
TN
01
—
P00800809
RAILROAD MEDICARE
TN
Enumeration date
03/19/2009
Last updated
06/09/2011
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