Provider Demographics
NPI:1902886609
Name:SANSBURY, PAUL ANDREWS III (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ANDREWS
Last Name:SANSBURY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 277700
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-7700
Mailing Address - Country:US
Mailing Address - Phone:440-717-6600
Mailing Address - Fax:440-546-8381
Practice Address - Street 1:101 E WOOD ST
Practice Address - Street 2:EMERGENCY CENTER
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3040
Practice Address - Country:US
Practice Address - Phone:864-560-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10360207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC189218OtherMEDCOST
SC20051880OtherSELECT HEALTH
SC103603Medicaid
SC7499174OtherAETNA
NC5803803Medicaid
SC103603Medicaid
SCP00333511Medicare PIN
SC189218OtherMEDCOST
SCD47052Medicare UPIN
SCD470529068Medicare PIN