Provider Demographics
NPI:1245232990
Name:SANCHEZ, RICHARD (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
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 1:16489 GLENEAGLES CT
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-7182
Mailing Address - Country:US
Mailing Address - Phone:219-669-0111
Mailing Address - Fax:
Practice Address - Street 1:16489 GLENEAGLES CT
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-7182
Practice Address - Country:US
Practice Address - Phone:219-669-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-017112085R0204X
IN01051929A2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00261945OtherRAILROAD MEDICARE
IN000000371808OtherBCBS
IN200456070Medicaid
IN000000371811OtherBCBS
IN000000371808OtherBCBS
IN200456070Medicaid
IN981290KMedicare ID - Type Unspecified