Organization
SANDERS MOBILE PODIATRY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY SANDERS DPM (PRESIDENT)
(410) 493-9439
Entity
Organization
Contact information
Practice address
1405 DECATUR ST, BALTIMORE, MD 21230-5212
(410) 493-9439
(443) 836-0722
Mailing address
1405 DECATUR ST, BALTIMORE, MD 21230-5212
(410) 493-9439
(443) 836-0722
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
E10000178
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01405
MARYLAND PODIATRY LIC#
MD
Enumeration date
06/22/2006
Last updated
06/30/2010
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