Healthcare Provider Details

I. General information

NPI: 1467672238
Provider Name (Legal Business Name): EDWARD MICHAEL SANGER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 03/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 FOUST ST STE C
ASHEBORO NC
27203-5476
US

IV. Provider business mailing address

713 S FAYETTEVILLE ST
ASHEBORO NC
27203-6667
US

V. Phone/Fax

Practice location:
  • Phone: 336-625-2333
  • Fax: 336-625-5511
Mailing address:
  • Phone: 336-625-2467
  • Fax: 336-625-2256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2005-01541
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: