Provider Demographics
NPI:1659435576
Name:SANDERS, STEPHEN BRIAN (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:BRIAN
Last Name:SANDERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CENTERVIEW DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-3725
Mailing Address - Country:US
Mailing Address - Phone:336-834-9664
Mailing Address - Fax:
Practice Address - Street 1:3 CENTERVIEW DR
Practice Address - Street 2:SUITE 150
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407
Practice Address - Country:US
Practice Address - Phone:336-641-3630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7974476Medicaid
NC203566HMedicare ID - Type Unspecified
NC7974476Medicaid