Provider Demographics
NPI:1396710836
Name:SANCHEZ, FEDERICO A (MD)
Entity type:Individual
Prefix:
First Name:FEDERICO
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 1:3003 W GOOD HOPE RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-2042
Mailing Address - Country:US
Mailing Address - Phone:414-352-3100
Mailing Address - Fax:
Practice Address - Street 1:N14W23833 STONE RIDGE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1157
Practice Address - Country:US
Practice Address - Phone:262-513-2033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI31197207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32806500Medicaid
WIP00823749OtherRR MEDICARE
WI462364679Medicare PIN
WIP00823749OtherRR MEDICARE
WI019940445Medicare PIN
WI32806500Medicaid