Individual
IVAN DANIEL SEQUERA SANCHEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 WASHINGTON ST # 298, ZIZKIND, BUILDING, 6TH FLOOR, BOSTON, MA 02111-1552
(617) 636-6044
(617) 636-8384
Mailing address
62 BOYLSTON ST, APT 418, BOSTON, MA 02116-4799
(312) 350-8469
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
260816
MA
390200000X
Student in an Organized Health Care Education/Training Program
11016499A
IN
Other
Enumeration date
07/13/2012
Last updated
01/15/2016
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