Provider Demographics
NPI:1891959136
Name:SANDERS, MICHELLE KING WEISS (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:KING WEISS
Last Name:SANDERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44405 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-5023
Mailing Address - Country:US
Mailing Address - Phone:248-858-3000
Mailing Address - Fax:
Practice Address - Street 1:1201 SOUTH DRIVE
Practice Address - Street 2:SUITE 220
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858
Practice Address - Country:US
Practice Address - Phone:989-317-4281
Practice Address - Fax:989-775-3187
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017911207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology