Individual
TIMOTHY JOSEPH SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 OMNI DR, SUITE A, SENECA, SC 29672-9448
(864) 885-7520
(864) 885-7521
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
LL28973
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-8715655
TAX ID
SC
05
—
289734
—
SC
05
—
GP4697
—
SC
Enumeration date
04/18/2007
Last updated
09/29/2014
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