Provider Demographics
NPI:1265670665
Name:HAIBA SONYIKA, MD, PC
Entity Type:Organization
Organization Name:HAIBA SONYIKA, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HAIBA
Authorized Official - Middle Name:
Authorized Official - Last Name:SONYIKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-817-6991
Mailing Address - Street 1:155 CARNEGIE PL
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-3981
Mailing Address - Country:US
Mailing Address - Phone:678-817-6991
Mailing Address - Fax:678-817-6992
Practice Address - Street 1:155 CARNEGIE PL
Practice Address - Street 2:SUITE 203
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-3981
Practice Address - Country:US
Practice Address - Phone:678-817-6991
Practice Address - Fax:678-817-6992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000441405HMedicaid
GAE88549Medicare UPIN