Provider Demographics
NPI:1003896770
Name:SANE, ANEYSA CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:ANEYSA
Middle Name:CHRISTINE
Last Name:SANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 WESLEY RD
Mailing Address - Street 2:
Mailing Address - City:DALEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24083-3082
Mailing Address - Country:US
Mailing Address - Phone:540-591-9447
Mailing Address - Fax:540-591-9932
Practice Address - Street 1:46 WESLEY RD
Practice Address - Street 2:
Practice Address - City:DALEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24083-3082
Practice Address - Country:US
Practice Address - Phone:540-591-9447
Practice Address - Fax:540-591-9932
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33195207KA0200X, 207RP1001X
VA0101247180207RP1001X, 207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
290014633OtherRR MEDICARE
VA6018122Medicaid
74468OtherBCBS
5828082OtherAETNA
VAQ33195Medicaid
20934OtherPARTNERS
2156963COtherMEDICARE PTAN
WV1811004000Medicaid
51247OtherMEDCOST
NC8974468Medicaid
E73039Medicare UPIN