Provider Demographics
NPI:1255319612
Name:SONDGERATH, ROBERT P (CRNA)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:P
Last Name:SONDGERATH
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 PEACHTREE ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-3505
Mailing Address - Country:US
Mailing Address - Phone:828-274-3477
Mailing Address - Fax:828-274-7407
Practice Address - Street 1:76 PEACHTREE ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3505
Practice Address - Country:US
Practice Address - Phone:828-274-3477
Practice Address - Fax:828-274-7407
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC211206163W00000X
NC036548367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL034600400Medicaid
NC8052695Medicaid
G1122Medicare ID - Type Unspecified
FL034600400Medicaid