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General NPI Number Information
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NPI Number | 1972328292
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Entity Type | Organization
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Legal Business Name | CORAZON-PANES SANCHEZ,LLC
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 815 EASTERN BLVD
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City | BALTIMORE
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State | MD
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Zip | 21221-3535
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Country | US
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Telephone | 410-642-9172
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Fax |
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Provider Business Mailing Address
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Address Line | 20 CRAIGTOWN RD STE 101
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City | PORT DEPOSIT
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State | MD
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Zip | 21904-1801
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Country | US
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Telephone | 410-642-9172
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | CORAZON SANCHEZ
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Credential |
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Telephone | 443-807-3442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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