MEDICARE: CHRISTOPHER D SANDS PA-C

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	363A00000X	Physician Assistant	PA00301	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508872615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER D SANDS PA-C

Provider Business Mailing Address
First Line	:	725 RESERVOIR AVE STE 103
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02910-4451
Country	:	US
Telephone Number	:	401-829-4446
Fax Number	:	401-829-4434

Provider Business Practice Location Address
First Line	:	725 RESERVOIR AVE STE 103
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02910-4451
Country	:	US
Telephone Number	:	401-829-4446
Fax Number	:	401-829-4434

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	09/25/2023

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Directions to “ CHRISTOPHER D SANDS PA-C” Practice Location

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