Provider Demographics
NPI:1124553789
Name:SANDERS, AMANDA B (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:B
Last Name:SANDERS
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 1:205 WEYER DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-8370
Mailing Address - Country:US
Mailing Address - Phone:859-912-0094
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF NORTH CAROLINA CB#7160
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-6101
Practice Address - Country:US
Practice Address - Phone:984-974-3881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-20
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC226895390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program