Provider Demographics
NPI:1396796314
Name:SANDERS, DONALD P (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:P
Last Name:SANDERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13332 MIDLOTHIAN TPKE
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-4210
Mailing Address - Country:US
Mailing Address - Phone:804-794-5598
Mailing Address - Fax:804-378-1954
Practice Address - Street 1:13332 MIDLOTHIAN TPKE
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-4210
Practice Address - Country:US
Practice Address - Phone:804-794-5598
Practice Address - Fax:804-378-1954
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101023406207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA116095OtherANTHEM
VA540883363OtherPHCS
VA879849OtherMAMSI
VA10521OtherCIGNA
VA539779OtherAETNA
VA540883363OtherVIRGINIA HEALTH NETWORK
VA540883363OtherFIRST HEALTH/CCN
VA28769OtherOPTIMA
VA540883363OtherCHAMPUS-TRICARE
VA540883363OtherGREAT WEST HEALTHCARE
VA540883363OtherPREFERRED CARE
VA5633923Medicaid
VA0100004OtherUNITED HEALTHCARE
VA540883363OtherCHAMPUS-TRICARE
VA080126472Medicare PIN
VA539779OtherAETNA
VA28769OtherOPTIMA
080006623Medicare PIN