Sander, Mary Susan

Sander, Mary Susan is an individual health care provider with primary practice located at 2726 Fulton Dr Nw , Canton OH 44718-3506. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Sander, Mary Susan can be contacted via phone (330) 455-5011.

Contact Information

Primary practice address
2726 Fulton Dr Nw Canton OH 44718-3506
Phone: (330) 455-5011
Fax: (330) 588-7127
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X NP-05340 Ohio

Profile Details

NPI number 1073503322
LBN Legal business name Sander, Mary Susan
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2005
Last updated May 12th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073503322 NPPES
Ohio MEDICAID 2179664
Ohio Other P00341076
Ohio Other 000000492313
Ohio Other 1073503322
Ohio Other 341773267G

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