Healthcare Provider Details

I. General information

NPI: 1063578516
Provider Name (Legal Business Name): SONALI HEMACHANDRA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 W SQUARE LAKE RD STE 113
BLOOMFIELD HILLS MI
48302-0462
US

IV. Provider business mailing address

7 W SQUARE LAKE RD STE 113
BLOOMFIELD HILLS MI
48302-0462
US

V. Phone/Fax

Practice location:
  • Phone: 248-266-5536
  • Fax: 248-206-3304
Mailing address:
  • Phone: 248-266-5536
  • Fax: 248-206-3304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License NumberEMC0005733
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: