Provider Demographics
NPI:1598865123
Name:SONNIE, CLIFFORD MICHAEL (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:MICHAEL
Last Name:SONNIE
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3985 MEDINA RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-5968
Mailing Address - Country:US
Mailing Address - Phone:330-764-4242
Mailing Address - Fax:
Practice Address - Street 1:3985 MEDINA RD
Practice Address - Street 2:SUITE 250
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-5968
Practice Address - Country:US
Practice Address - Phone:330-764-4242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0490662083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHE30059Medicare UPIN