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General NPI Number Information
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NPI Number | 1457541971
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Entity Type | Individual
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Provider Name | SONAL J BAZELEY MD
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Gender | Female
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Dates
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Enumeration Date | 07/31/2007
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 2401 W UNIVERSITY AVE
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City | MUNCIE
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State | IN
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Zip | 47303-3428
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Country | US
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Telephone | 765-751-2649
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Fax | 765-281-6671
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Provider Business Mailing Address
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Address Line | 250 N SHADELAND AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4959
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 01070222A
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License Number State | IN
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