Individual
MR. PAUL SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4500 STUART ST, MONCRIEF ARMY COMMUNITY HOSPITAL/CREDENTIALS, COLUMBIA, SC 29207-5700
(803) 751-2618
(803) 751-2689
Mailing address
4500 STUART STREET, MONCRIEF ARMY HOSPITAL, ATTN:MCXL-PQ(CREDENTIALS), FORT JACKSON, SC 29207-5720
(803) 751-2618
(803) 751-2689
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
NCCPA#1027537
—
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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