MEDICARE: DR. SONJA DOUGHLIN MD

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	207R00000X	Internal Medicine Physician	310782	NY
2	207R00000X	Internal Medicine Physician	ME137554	FL
3	207R00000X	Internal Medicine Physician	36332	SC
4	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician	078289	GA
5	207R00000X	Internal Medicine Physician	78289	GA

General Provider Information

NPI Number	:	1295984979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SONJA DOUGHLIN MD

Provider Business Mailing Address
First Line	:	2727 PACES FERRY RD SE STE 1-1100
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-6151
Country	:	US
Telephone Number	:	404-605-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 RIVEREDGE PKWY STE 5005TH
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-4693
Country	:	US
Telephone Number	:	866-949-0108
Fax Number	:

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

Provider Enumeration Date	:	09/17/2008
Last Update Date	:	04/12/2023

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