MEDICARE: SONIA VERONICA EDEN 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	207T00000X	Neurological Surgery Physician	29570	MS
2	207T00000X	Neurological Surgery Physician	4301075914	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518002070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONIA VERONICA EDEN M.D.

Provider Business Mailing Address
First Line	:	4160 JOHN R ST STE 925
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48201-2017
Country	:	US
Telephone Number	:	313-745-7247
Fax Number	:

Provider Business Practice Location Address
First Line	:	4160 JOHN R ST STE 925
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48201-2017
Country	:	US
Telephone Number	:	313-745-7247
Fax Number	:

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

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	11/05/2021

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Directions to “ SONIA VERONICA EDEN M.D.” Practice Location

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