Provider Demographics
NPI:1346656782
Name:SANCHEZ LUNA, SERGIO ALEJANDRO (MD)
Entity Type:Individual
Prefix:DR
First Name:SERGIO
Middle Name:ALEJANDRO
Last Name:SANCHEZ LUNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 7TH AVE S # BDB377
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1912
Mailing Address - Country:US
Mailing Address - Phone:205-934-4744
Mailing Address - Fax:205-934-4468
Practice Address - Street 1:1808 7TH AVE S # BDB377
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1912
Practice Address - Country:US
Practice Address - Phone:205-934-4744
Practice Address - Fax:205-934-4468
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL41846207RG0100X
NM390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103770986Medicaid
14655951OtherCAQH