Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 037669 | GA |
NPI | 1053379495 |
---|---|
Provider Name | Dr. William Holt Sanders |
First Address | Atlanta, GA 30326-1000 |
Second Address | Atlanta, GA 30342-1626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F79934 | (02) |