Provider Demographics
NPI:1518048842
Name:SANCHEZ, JASON LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:LOUIS
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6200 SHINGLE CREEK PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-2128
Mailing Address - Country:US
Mailing Address - Phone:763-561-5986
Mailing Address - Fax:763-561-7792
Practice Address - Street 1:2545 CHICAGO AVE
Practice Address - Street 2:SUITE 17200
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4522
Practice Address - Country:US
Practice Address - Phone:612-799-1939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN43565207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
H04707Medicare UPIN