Healthcare Provider Details

I. General information

NPI: 1407811599
Provider Name (Legal Business Name): SONIA K MEYERS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 01/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 HIGHLAND AVE
MADISON WI
53792-0001
US

IV. Provider business mailing address

600 HIGHLAND AVE
MADISON WI
53792-0001
US

V. Phone/Fax

Practice location:
  • Phone: 608-263-5442
  • Fax:
Mailing address:
  • Phone: 608-263-5442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number1564
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number50373
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: