Provider Demographics
NPI:1447430426
Name:SAUNDERS, MARC S (DO)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:S
Last Name:SAUNDERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 N E ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-6339
Mailing Address - Country:US
Mailing Address - Phone:850-437-8810
Mailing Address - Fax:850-437-8809
Practice Address - Street 1:1717 N E ST
Practice Address - Street 2:SUITE 205
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-6339
Practice Address - Country:US
Practice Address - Phone:850-437-8810
Practice Address - Fax:850-437-8809
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34005874208600000X
FLOS14047208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019404100Medicaid
OH0967333Medicaid
FL9KWYPOtherFLORIDA BLUE
OHF77835Medicare UPIN
OHSA0758931Medicare PIN
FL9KWYPOtherFLORIDA BLUE