Individual
JOSE MAURICIO SANCHEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
450 N NEW BALLAS RD, STE 270 W, SAINT LOUIS, MO 63141-6835
(314) 991-6969
(314) 997-6969
Mailing address
450 N NEW BALLAS RD, STE 270 W, SAINT LOUIS, MO 63141-6835
(314) 991-6969
(314) 997-6969
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
2003006585
MO
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
2003006585
MO
207RI0011X
Interventional Cardiology Physician
2003006585
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346336815
—
MO
01
—
969722762
MEDICARE PROVIDER ID
MO
01
—
P00847513
RAILROAD MEDICARE
MO
Enumeration date
10/04/2006
Last updated
01/19/2016
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