Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 35049770 | OH |
NPI | 1023013976 |
---|---|
Provider Name | Jiri David Sonek |
First Address | Dayton, OH 45409-2722 |
Second Address | Dayton, OH 45409-2722 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 14/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000122997 | ANTHEM PIN (01) | OH |
0531777 | (05) | OH |
A80794 | (02) | OH |