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General NPI Number Information
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NPI Number | 1124219076
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Entity Type | Individual
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Provider Name | DAVID D SANDERS CRNA
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Gender | Male
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 07/10/2014
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Provider Practice Location Address
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Address Line | 1509 GILSTRAP LN NW
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City | ATLANTA
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State | GA
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Zip | 30318-2775
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Country | US
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Telephone | 404-210-8886
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Fax | 678-620-2242
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Provider Business Mailing Address
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Address Line | 1509 GILSTRAP LN NW
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City | ATLANTA
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State | GA
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Zip | 30318-2775
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Country | US
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Telephone | 404-210-8886
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Fax | 770-696-1698
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN078001
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License Number State | GA
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