MEDICARE: ZACHARY SANDERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347C00000X	Private Vehicle	1633GV	NC

General Provider Information

NPI Number	:	1417732918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY SANDERS

Provider Business Mailing Address
First Line	:	310 FREEMONT DR
Second Line	:
City	:	THOMASVILLE
State	:	NC
Zip	:	27360-6371
Country	:	US
Telephone Number	:	336-423-1917
Fax Number	:

Provider Business Practice Location Address
First Line	:	2018 W GREEN DR
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27260-8709
Country	:	US
Telephone Number	:	336-423-1917
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2023
Last Update Date	:	08/31/2023

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Directions to “ ZACHARY SANDERS ” Practice Location

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