Healthcare Provider Details

I. General information

NPI: 1578579082
Provider Name (Legal Business Name): ELIZABETH A SANDERS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 02/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 PILLSBURY ST SUITE 401
CONCORD NH
03301-3502
US

IV. Provider business mailing address

2 PILLSBURY ST SUITE 401
CONCORD NH
03301-3502
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-7575
  • Fax: 603-228-7255
Mailing address:
  • Phone: 603-224-7575
  • Fax: 603-228-7255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9102
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: