Healthcare Provider Details
I. General information
NPI: 1780031393
Provider Name (Legal Business Name): SANDERS OH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/24/2016
Last Update Date: 04/10/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
UNITED STATES NAVAL HOSPITAL OKINAWA BLDG 960 CAMP FOSTER
FPO AP
96362
US
IV. Provider business mailing address
PSC 482 BOX 3051
FPO AP
96362-0031
US
V. Phone/Fax
- Phone: 98-971-9355
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171000000X |
| Taxonomy | Military Health Care Provider |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | M-2424 |
| License Number State | GU |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 0101263434 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: