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General NPI Number Information
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NPI Number | 1306167564
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Entity Type | Individual
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Provider Name | DANIELLE TERESA SANDERS M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/22/2010
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 3901 LIBERTY ST
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City | ERIE
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State | PA
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Zip | 16509-1689
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Country | US
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Telephone | 814-864-5595
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Fax |
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Provider Business Mailing Address
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Address Line | 4022 SANDALWOOD DR
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City | ERIE
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State | PA
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Zip | 16506-4764
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Country | US
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Telephone | 814-833-5124
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD441741
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License Number State | PA
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