Provider Demographics
NPI:1497948301
Name:SHAHRAWAT, SONIA M (MD)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:M
Last Name:SHAHRAWAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:C B 8054
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-454-6215
Mailing Address - Fax:314-454-2296
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-6215
Practice Address - Fax:314-454-2296
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006036027207L00000X, 207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILENROLLEDMedicaid
MO207022203Medicaid
IL$$$$$$$$$Medicaid
AR175755001Medicaid
LA2322851Medicaid
TNQ005623Medicaid
MO329040174Medicaid
OK200226160AMedicaid
OH0054741Medicaid
IA1497948301Medicaid
TX2102006-01Medicaid
FL917779000Medicaid
KY7100198820Medicaid
GA897114884AMedicaid