Provider Demographics
NPI:1669476628
Name:SANCHEZ, CARLOS A (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:A
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 1:2301 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-4154
Mailing Address - Country:US
Mailing Address - Phone:717-397-2738
Mailing Address - Fax:717-397-7634
Practice Address - Street 1:LANCASTER INTERNAL MEDICINE GROUP
Practice Address - Street 2:817 NORTH CHERRY STREET
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602
Practice Address - Country:US
Practice Address - Phone:717-393-8131
Practice Address - Fax:717-393-9107
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA069410L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA60396OtherGEISINGER HEALTHPLAN PROV
PA0018124760001Medicaid
PA2370818OtherAETNA US HEALTHCARE PROVI
PA623835OtherBLUE SHIELD PROVIDER #
PA9238956001OtherCIGNA PROVIDER NUMBER
PA01031401OtherCAPITAL BLUE CROSS PROV#
PA60396OtherGEISINGER HEALTHPLAN PROV
PA0018124760001Medicaid