Healthcare Provider Details

I. General information

NPI: 1306964622
Provider Name (Legal Business Name): ANGELA PAULETTE SANDERS-CLIETTE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2039 WILLOW SPRING LN C
BURLINGTON NC
27215-8854
US

IV. Provider business mailing address

309 N RIVERDALE DR
DURHAM NC
27712-2071
US

V. Phone/Fax

Practice location:
  • Phone: 336-222-7566
  • Fax: 336-436-6125
Mailing address:
  • Phone: 919-383-0175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number94-00141
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: