Individual
RICARDO ALEJANDRO SEQUEIRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-9355
Mailing address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-9355
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
27493
NE
2083A0100X
Aerospace Medicine Physician
Primary
38952
AL
Other
Enumeration date
06/06/2012
Last updated
07/10/2023
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