Provider Demographics
NPI:1619010980
Name:SANCHEZ, EDGAR H (MD)
Entity Type:Individual
Prefix:
First Name:EDGAR
Middle Name:H
Last Name:SANCHEZ
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 1:4100 JOHNSON RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2356
Mailing Address - Country:US
Mailing Address - Phone:740-264-7800
Mailing Address - Fax:740-264-2334
Practice Address - Street 1:4100 JOHNSON RD
Practice Address - Street 2:SUITE 208
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2356
Practice Address - Country:US
Practice Address - Phone:740-264-7800
Practice Address - Fax:740-264-2334
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-06-5142-S207RP1001X
PAMD-046688-L207RP1001X
WV17373207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1460426Medicaid
OH0926798Medicaid
WV0075820000Medicaid
OH0926798Medicaid
OH0740312Medicare PIN
OHF59773Medicare UPIN