Sanders, Mitchell Wayne

Sanders, Mitchell Wayne is an individual health care provider with primary practice located at 2601 W Main St , Carbondale IL 62901-1031. He recently has 3 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Sanders, Mitchell Wayne can be contacted via phone (618) 549-5361.

Contact Information

Primary practice address
2601 W Main St Carbondale IL 62901-1031
Phone: (618) 549-5361
Fax: (618) 351-4878
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085008547 Illinois

Profile Details

NPI number 1528680162
LBN Legal business name Sanders, Mitchell Wayne
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2020
Last updated Dec 9th, 2021 - about 3 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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