Provider Demographics
NPI:1699892562
Name:SANCHEZ, MIGUEL E
Entity type:Individual
Prefix:
First Name:MIGUEL
Middle Name:E
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1743 MINERVA WAY
Mailing Address - Street 2:SEMA
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-1490
Mailing Address - Country:US
Mailing Address - Phone:907-346-4410
Mailing Address - Fax:907-346-4412
Practice Address - Street 1:1743 MINERVA WAY
Practice Address - Street 2:SEMA
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-1490
Practice Address - Country:US
Practice Address - Phone:907-346-4410
Practice Address - Fax:907-346-4412
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100469310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility