Provider Demographics
NPI:1548353410
Name:SANCHEZ, KIMBERLY W (MD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:W
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:D
Other - Last Name:WOLFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:160 NORTH POINT BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601
Mailing Address - Country:US
Mailing Address - Phone:717-569-6481
Mailing Address - Fax:717-569-5213
Practice Address - Street 1:160 NORTH POINT BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601
Practice Address - Country:US
Practice Address - Phone:717-569-6481
Practice Address - Fax:717-569-5213
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD428640208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAI65760OtherHEALTH AMERICA
PA1017273960001Medicaid
PA103846OtherGEISINGER HEALTH PLAN
PA20056398OtherAMERIHEALTH MERCY HEALTH
PAP007002OtherGATEWAY HEALTH PLAN
PA1895604OtherHIGHMARK BLUE SHIELD
PA50062540OtherCAPITAL BLUE CROSS
PA7933848OtherAETNA NON-HMO
PA1452184OtherAETNA HMO
PA103846OtherGEISINGER HEALTH PLAN
PA1452184OtherAETNA HMO