Healthcare Provider Details

I. General information

NPI: 1336501576
Provider Name (Legal Business Name): RAUL SANCHEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2016
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 N CLEVELAND AVE
WESTERVILLE OH
43082-8095
US

IV. Provider business mailing address

700 CHILDREN'S DRIVE
COLUMBUS OH
43205-2664
US

V. Phone/Fax

Practice location:
  • Phone: 614-355-8300
  • Fax:
Mailing address:
  • Phone: 614-722-2000
  • Fax: 614-722-4380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number35136564
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35136564
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number35136564
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: