Provider Demographics
NPI:1194583260
Name:SAUNDERS, MITCHELL SCOTT
Entity type:Individual
Prefix:
First Name:MITCHELL
Middle Name:SCOTT
Last Name:SAUNDERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 SANS SOUCI ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-3240
Mailing Address - Country:US
Mailing Address - Phone:864-395-2021
Mailing Address - Fax:
Practice Address - Street 1:4 SUNSET WAY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-2015
Practice Address - Country:US
Practice Address - Phone:702-968-7076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program