Provider Demographics
NPI:1700197167
Name:GERALD, SONJA ZANETA (MD)
Entity Type:Individual
Prefix:DR
First Name:SONJA
Middle Name:ZANETA
Last Name:GERALD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1160 VARNUM ST NE STE 117
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2106
Mailing Address - Country:US
Mailing Address - Phone:240-670-1003
Mailing Address - Fax:240-532-5071
Practice Address - Street 1:4744 MARLBORO PIKE
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-5212
Practice Address - Country:US
Practice Address - Phone:240-670-1003
Practice Address - Fax:240-532-5071
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD76180207R00000X
DCMD042488207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD138135100Medicaid
DC081592604Medicaid