Healthcare Provider Details

I. General information

NPI: 1821406232
Provider Name (Legal Business Name): IVAN SANCHEZ FERNANDEZ MD, MPH, MBI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2014
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CLEVELAND CLINIC 9500 EUCLID AVENUE/JJ24
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

CLEVELAND CLINIC 9500 EUCLID AVENUE/JJ24
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-2200
  • Fax:
Mailing address:
  • Phone: 216-444-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number291456
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number291456
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number291456
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number35.155569
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: