Provider Demographics
NPI:1790747848
Name:SANCHEZ, PAMELA A (MD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:A
Last Name:SANCHEZ
Suffix:
Gender:F
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 1:6938 ELM VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-7447
Mailing Address - Country:US
Mailing Address - Phone:269-552-4233
Mailing Address - Fax:269-552-4216
Practice Address - Street 1:6938 ELM VALLEY DR
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-7447
Practice Address - Country:US
Practice Address - Phone:269-552-4233
Practice Address - Fax:269-552-4216
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301059556207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI319817Medicaid
MI319817Medicaid
MIG20077Medicare UPIN