Doctor Name: | MR. SONJAI POONPANIJ |
NPI Number: | 1891895462 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 4301032562 |
Business Practice Address: | 1607 E Big Beaver Rd Ste 200 Troy, MI - 480832068 |
Business Phone Number: | 2487431099 |
Business Fax Number: | 2487431095 |
Mailing Address: | Po Box 80938, ROCHESTER |
State: | MI |
Postal Code: | 483080938 |
Phone Number: | 2487431099 |
Fax Number: | 2487431095 |
NPI Enumeration Date: | 09/24/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 4301032562 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |