Provider Demographics
NPI:1528389947
Name:WHITAKER, SONJA MARTINA STEFANIE (MD, PHD)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:MARTINA STEFANIE
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:SONJA
Other - Middle Name:MARTINA STEFANIE
Other - Last Name:UTHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD,PHD
Mailing Address - Street 1:PO BOX 2699
Mailing Address - Street 2:ATTN: SHMG/HPE
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32513-2699
Mailing Address - Country:US
Mailing Address - Phone:850-416-0020
Mailing Address - Fax:850-492-6340
Practice Address - Street 1:13139 SORRENTO RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-8777
Practice Address - Country:US
Practice Address - Phone:850-416-0020
Practice Address - Fax:850-492-6340
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01072525A207Q00000X
FLME125279207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine