Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 01049583 | IN |
NPI | 1528097136 |
---|---|
Provider Name | Juan C Sanchez |
First Address | Indianapolis, IN 46206-1026 |
Second Address | Indianapolis, IN 46202-5109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 04/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000321538 | ANTHEM-DEAC-350593390 (01) | |
1021359 | (05) | VT |
200201640 | (05) | IN |
350593390-042 | TRICARE-DEAC-350593390 (01) | |
350593390-042 | TRICARE-UPA-237328642 (01) | |
64881824 | (05) | KY |
F49579 | (02) |