Provider Demographics
NPI:1811983349
Name:SANEL, HENRY B (MD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:B
Last Name:SANEL
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:PO BOX 93806
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85070-3806
Mailing Address - Country:US
Mailing Address - Phone:480-361-7680
Mailing Address - Fax:480-361-7683
Practice Address - Street 1:8300 N HAYDEN RD
Practice Address - Street 2:STE: A103
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-2458
Practice Address - Country:US
Practice Address - Phone:480-632-8919
Practice Address - Fax:480-632-8940
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ23046174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ19651001Medicaid
AZWMBPZ01Medicare ID - Type Unspecified
AZ19651001Medicaid