Healthcare Provider Details

I. General information

NPI: 1871723445
Provider Name (Legal Business Name): WILLIAM G SANDERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2009
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18101 OAKWOOD BLVD
DEARBORN MI
48123-4089
US

IV. Provider business mailing address

38935 ANN ARBOR RD
LIVONIA MI
48150-3397
US

V. Phone/Fax

Practice location:
  • Phone: 313-593-8780
  • Fax: 313-436-2864
Mailing address:
  • Phone: 734-632-0175
  • Fax: 888-250-6385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036130213
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number4301094706
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: