Healthcare Provider Details

I. General information

NPI: 1144832932
Provider Name (Legal Business Name): SONYA WALI DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2020
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 N PARK AVE GN1
CHEVY CHASE MD
20815-4518
US

IV. Provider business mailing address

4600 N PARK AVE GN1
CHEVY CHASE MD
20815-4518
US

V. Phone/Fax

Practice location:
  • Phone: 240-641-8735
  • Fax: 240-641-8740
Mailing address:
  • Phone:
  • Fax: 240-641-8740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number01818
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0103301420
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberP050083043
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: