Provider Demographics
NPI:1134117013
Name:SCHATZ, SANFORD L (MD)
Entity Type:Individual
Prefix:
First Name:SANFORD
Middle Name:L
Last Name:SCHATZ
Suffix:
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 1:20 CATAMORE BLVD
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-1204
Mailing Address - Country:US
Mailing Address - Phone:401-432-2520
Mailing Address - Fax:401-432-2457
Practice Address - Street 1:20 CATAMORE BLVD
Practice Address - Street 2:RHODE ISLAND MEDICAL IMAGING
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-1204
Practice Address - Country:US
Practice Address - Phone:401-432-2520
Practice Address - Fax:401-432-2457
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI60142085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1600203OtherUNITED HEALTH PLANS
240608OtherRIH PILGRIM
006014OtherTUFTS
MA3202151Medicaid
002027OtherBLUECHIP
006014OtherBLUESHIELD
000000001988OtherNHPRI
3202151OtherHEALTHY START
RI7000701OtherMEDICAL ASSISTANCE
240608OtherRIH PILGRIM