Provider Demographics
NPI:1578756383
Name:PANESAR, SONIA KAUR (MD)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:KAUR
Last Name:PANESAR
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 1:2315 MYRTLE ST STE G30
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-4610
Mailing Address - Country:US
Mailing Address - Phone:814-452-5504
Mailing Address - Fax:814-452-5514
Practice Address - Street 1:2315 MYRTLE ST STE G30
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-4610
Practice Address - Country:US
Practice Address - Phone:814-452-5504
Practice Address - Fax:814-452-5514
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD445532207V00000X
MDP21927207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036123718Medicaid