MEDICARE: IVY E SOHN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	216085	MA

General Provider Information

NPI Number	:	1154446003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVY E SOHN M.D.

Provider Business Mailing Address
First Line	:	202 WHITCOMB LN
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27511-8638
Country	:	US
Telephone Number	:	919-733-5232
Fax Number	:

Provider Business Practice Location Address
First Line	:	OF FORENSIC PSYCHIATRY # CD7160
Second Line	:	101 MANNING ST, 1ST FLR
City	:	CHAPEL HILL
State	:	NC
Zip	:	27599-7160
Country	:	US
Telephone Number	:	919-733-5232
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	07/08/2007

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