MEDICARE: DR. SUKHDEV C SONI 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	174400000X	Specialist	0101237900	VA

General Provider Information

NPI Number	:	1912906264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUKHDEV C SONI MD

Provider Business Mailing Address
First Line	:	895 MIDDLE GROUND BLVD
Second Line	:	BLDG 200
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23606-4250
Country	:	US
Telephone Number	:	757-873-9400
Fax Number	:	757-213-5701

Provider Business Practice Location Address
First Line	:	3000 COLISEUM DR
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23666-5963
Country	:	US
Telephone Number	:	757-827-9400
Fax Number	:	757-213-5701

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	08/15/2007

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