MEDICARE: DR. DEBORAH MAYHEW SANDERSON D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	0104556193	VA
2	111N00000X	Chiropractor	CH7477	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	242876	OTHER	VA	SOUTHER HEALTH PIN NUMBER
2	71965538	OTHER	VA	AETNA PIN NUMBER
3	103382	OTHER	VA	BC/BS PIN NUMBER
4	2219233	OTHER	VA	CIGNA'S PIN NUMBER

General Provider Information

NPI Number	:	1104834480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH MAYHEW SANDERSON D.C.

Provider Business Mailing Address
First Line	:	1550 INSURANCE LN
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22911-7229
Country	:	US
Telephone Number	:	434-296-8100
Fax Number	:	434-975-1023

Provider Business Practice Location Address
First Line	:	1550 INSURANCE LN
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22911-7229
Country	:	US
Telephone Number	:	434-296-8100
Fax Number	:	434-975-1023

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	07/09/2007

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Directions to “ DR. DEBORAH MAYHEW SANDERSON D.C.” Practice Location

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