Provider Demographics
NPI:1326565177
Name:FREDRIC M SONSTEIN MD MBA PLLC
Entity Type:Organization
Organization Name:FREDRIC M SONSTEIN MD MBA PLLC
Other - Org Name:BRAIN AND SPINE INJURY SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDRIC
Authorized Official - Middle Name:
Authorized Official - Last Name:SONSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-789-5195
Mailing Address - Street 1:333 W HAMPDEN AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-2338
Mailing Address - Country:US
Mailing Address - Phone:303-789-5195
Mailing Address - Fax:720-306-5267
Practice Address - Street 1:333 W HAMPDEN AVE STE 800
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110
Practice Address - Country:US
Practice Address - Phone:303-789-5195
Practice Address - Fax:720-306-5267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-23
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty