Provider Demographics
NPI:1346874591
Name:FIELDS, SONIA KARADJOFF (RPH)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:KARADJOFF
Last Name:FIELDS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 MAYFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-1269
Mailing Address - Country:US
Mailing Address - Phone:248-342-4599
Mailing Address - Fax:248-547-2591
Practice Address - Street 1:209 E 12 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-4114
Practice Address - Country:US
Practice Address - Phone:248-548-6180
Practice Address - Fax:248-414-5755
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302030409183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist