Individual
BLAKE SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
170 MEDICAL PARK RD STE 203, MOORESVILLE, NC 28117-8540
(980) 550-2400
(980) 550-2424
Mailing address
170 MEDICAL PARK RD STE 203, MOORESVILLE, NC 28117-8540
(980) 550-2400
(980) 550-2424
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2021-03162
NC
207N00000X
Dermatology Physician
OS020540
PA
Other
Enumeration date
02/22/2016
Last updated
12/29/2021
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