Provider Demographics
NPI:1386637981
Name:SOGOL, ELLIOTT MICHAEL (RPH)
Entity Type:Individual
Prefix:DR
First Name:ELLIOTT
Middle Name:MICHAEL
Last Name:SOGOL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3828 SWEETEN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-9706
Mailing Address - Country:US
Mailing Address - Phone:919-408-8208
Mailing Address - Fax:
Practice Address - Street 1:8210 RENAISSANCE PARKWAY
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713
Practice Address - Country:US
Practice Address - Phone:919-425-0001
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11663183500000X
WI9814183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist