Provider Demographics
NPI:1336674357
Name:VARGHESE, SONIA ANN (MD MPH MBA)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:ANN
Last Name:VARGHESE
Suffix:
Gender:F
Credentials:MD MPH MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7031 VILLA MOUNTAIN LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379
Mailing Address - Country:US
Mailing Address - Phone:832-490-7763
Mailing Address - Fax:
Practice Address - Street 1:510 CAROLINA BAY DR STE 200
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-2046
Practice Address - Country:US
Practice Address - Phone:910-662-8888
Practice Address - Fax:910-662-8906
Is Sole Proprietor?:No
Enumeration Date:2017-04-27
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC228185390200000X
NC2022-023992084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program