Provider Demographics
NPI:1306167564
Name:SANDERS, DANIELLE TERESA (MD)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:TERESA
Last Name:SANDERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DANIELLE
Other - Middle Name:TERESA
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4022 SANDALWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-4764
Mailing Address - Country:US
Mailing Address - Phone:814-833-5124
Mailing Address - Fax:
Practice Address - Street 1:3901 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-1689
Practice Address - Country:US
Practice Address - Phone:814-864-5595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD441741207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine