Healthcare Provider Details

I. General information

NPI: 1093781395
Provider Name (Legal Business Name): MANUEL G SANCHEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 05/27/2022
Certification Date: 05/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 SHATTUCK WAY STE 6
NEWINGTON NH
03801-7876
US

IV. Provider business mailing address

101 SHATTUCK WAY STE 6
NEWINGTON NH
03801-7876
US

V. Phone/Fax

Practice location:
  • Phone: 603-778-9921
  • Fax:
Mailing address:
  • Phone: 603-778-9921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number8136
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number8136
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: