Provider Demographics
NPI:1699866897
Name:CARDENAS, ANA SANCHEZ (MD)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:SANCHEZ
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 N MICHIGAN STREET
Mailing Address - Street 2:SUITE 308
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46601
Mailing Address - Country:US
Mailing Address - Phone:574-239-4602
Mailing Address - Fax:574-239-4607
Practice Address - Street 1:610 N MICHIGAN STREET
Practice Address - Street 2:SUITE 308
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601
Practice Address - Country:US
Practice Address - Phone:574-239-4602
Practice Address - Fax:574-239-4607
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01034537207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100333930AMedicaid
IN100333930AMedicaid
IN163500BMedicare PIN