Provider Demographics
NPI:1013012376
Name:ESTRUCH, SONIA (MD)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:
Last Name:ESTRUCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21286-1564
Mailing Address - Country:US
Mailing Address - Phone:410-821-0548
Mailing Address - Fax:
Practice Address - Street 1:PERRY POINT VA MEDICAL CENTER
Practice Address - Street 2:PERRY POINT
Practice Address - City:PERRY POINT
Practice Address - State:MD
Practice Address - Zip Code:21902
Practice Address - Country:US
Practice Address - Phone:410-642-1141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0001572208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation