Provider Demographics
NPI:1578667572
Name:SAULL, SONDRA C (MD)
Entity Type:Individual
Prefix:
First Name:SONDRA
Middle Name:C
Last Name:SAULL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:375 TOWNSHIP LINE RD
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2239
Mailing Address - Country:US
Mailing Address - Phone:215-887-7380
Mailing Address - Fax:215-887-7373
Practice Address - Street 1:1650 HUNTINGDON PIKE
Practice Address - Street 2:SUITE 214
Practice Address - City:MEADOWBROOK
Practice Address - State:PA
Practice Address - Zip Code:19046
Practice Address - Country:US
Practice Address - Phone:215-938-8400
Practice Address - Fax:215-938-7013
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2016-12-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD025678E207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B41991Medicare UPIN