Provider Demographics
NPI:1376281196
Name:SANDERS, DELANTE ANTHONY
Entity Type:Individual
Prefix:MR
First Name:DELANTE
Middle Name:ANTHONY
Last Name:SANDERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 SAVANNAH TER SE APT 11
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-2077
Mailing Address - Country:US
Mailing Address - Phone:202-867-2010
Mailing Address - Fax:
Practice Address - Street 1:2240 SAVANNAH TER SE APT 11
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-2077
Practice Address - Country:US
Practice Address - Phone:202-867-2010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC284240Medicaid