Healthcare Provider Details

I. General information

NPI: 1093867137
Provider Name (Legal Business Name): SHEREE SAUNDERS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USS IWO JIMA (LHD-7) MEDICAL DEPARTMENT
FPO AE
09574-1664
US

IV. Provider business mailing address

521 BOISSEVAIN AVE APT 29B
NORFOLK VA
23507-2106
US

V. Phone/Fax

Practice location:
  • Phone: 757-443-8007
  • Fax:
Mailing address:
  • Phone: 301-346-5680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0065033
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: