Healthcare Provider Details

I. General information

NPI: 1447456959
Provider Name (Legal Business Name): SONAL A PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 EDEN WAY N STE 101
CHESAPEAKE VA
23320-3336
US

IV. Provider business mailing address

667 KINGSBOROUGH SQ STE 101
CHESAPEAKE VA
23320-4999
US

V. Phone/Fax

Practice location:
  • Phone: 757-312-6267
  • Fax: 757-819-7185
Mailing address:
  • Phone: 757-842-4481
  • Fax: 757-312-3135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number263061
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: