MEDICARE: DR. AMANDA B SANDERS M.D.

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	390200000X	Student in an Organized Health Care Education/Training Program	226895	NC

General Provider Information

NPI Number	:	1124553789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA B SANDERS M.D.

Provider Business Mailing Address
First Line	:	205 WEYER DR
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-8370
Country	:	US
Telephone Number	:	859-912-0094
Fax Number	:

Provider Business Practice Location Address
First Line	:	UNIVERSITY OF NORTH CAROLINA CB#7160
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27599-6101
Country	:	US
Telephone Number	:	984-974-3881
Fax Number	:

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

Provider Enumeration Date	:	04/20/2017
Last Update Date	:	05/09/2017

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