Healthcare Provider Details

I. General information

NPI: 1891957122
Provider Name (Legal Business Name): SONAR X INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2008
Last Update Date: 07/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26222 TELEGRAPH RD SUITE 100
SOUTHFIELD MI
48033-5318
US

IV. Provider business mailing address

26222 TELEGRAPH RD SUITE 100
SOUTHFIELD MI
48033-5318
US

V. Phone/Fax

Practice location:
  • Phone: 248-827-7200
  • Fax: 248-827-2641
Mailing address:
  • Phone: 248-827-7200
  • Fax: 248-827-2641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: PRASKASH GANDHI
Title or Position: PRESIDENT
Credential:
Phone: 248-827-7200