Provider Demographics
NPI:1396852927
Name:SONNANSTINE, THOMAS E IV (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:SONNANSTINE
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5400 FRANTZ RD
Mailing Address - Street 2:STE 250
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4144
Mailing Address - Country:US
Mailing Address - Phone:614-544-6155
Mailing Address - Fax:
Practice Address - Street 1:3773 OLENTANGY RIVER RD
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3425
Practice Address - Country:US
Practice Address - Phone:614-566-3946
Practice Address - Fax:614-566-1212
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2022-01-05
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Provider Licenses
StateLicense IDTaxonomies
OH35085182208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64080237Medicaid
IN200505460Medicaid
OH2489669Medicaid
OH2489669Medicaid
KY64080237Medicaid
IN200505460Medicaid
KY00956001Medicare PIN
KY0969458Medicare PIN