Provider Demographics
NPI:1629020441
Name:CAHANAP-MERCADO, SONIA ORELLANA (MD)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:ORELLANA
Last Name:CAHANAP-MERCADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SONIA
Other - Middle Name:ORELLANA
Other - Last Name:MERCADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1923 FARROW DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732
Mailing Address - Country:US
Mailing Address - Phone:803-909-2041
Mailing Address - Fax:803-981-7438
Practice Address - Street 1:222 S HERLONG AVENUE
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732
Practice Address - Country:US
Practice Address - Phone:803-909-2041
Practice Address - Fax:803-981-7438
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC220872080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT63339Medicaid
E62863Medicare UPIN