Provider Demographics
NPI:1750614723
Name:SANCHEZ, JOAN A (IDMT)
Entity type:Individual
Prefix:MR
First Name:JOAN
Middle Name:A
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 ABERDEEN RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-4601
Mailing Address - Country:US
Mailing Address - Phone:910-286-9744
Mailing Address - Fax:
Practice Address - Street 1:1113 ABERDEEN RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-4601
Practice Address - Country:US
Practice Address - Phone:910-286-9744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians