Provider Demographics
NPI:1225315997
Name:SONSYNATH, DAROUNY ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:DAROUNY
Middle Name:ANN
Last Name:SONSYNATH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3990 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-1527
Mailing Address - Country:US
Mailing Address - Phone:810-987-4679
Mailing Address - Fax:810-987-4694
Practice Address - Street 1:3990 24TH AVE
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-1527
Practice Address - Country:US
Practice Address - Phone:810-987-4679
Practice Address - Fax:810-987-4694
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033121183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2361260Medicaid
MI1073520060Medicare NSC