Basic Information
| Provider Information | |||||||||
| NPI: | 1386639664 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANCHEZ | ||||||||
| FirstName: | JUAN | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3407 WILKENS AVE | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212295072 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103682730 | ||||||||
| FaxNumber: | 4109514007 | ||||||||
| Practice Location | |||||||||
| Address1: | 3407 WILKENS AVE | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212295072 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103682730 | ||||||||
| FaxNumber: | 4109514007 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2005 | ||||||||
| LastUpdateDate: | 08/28/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | D75512 | MD | N | Allopathic & Osteopathic Physicians | Surgery | 208G00000X | D75512 | MD | Y | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
No ID Information.