Provider Demographics
NPI:1801004866
Name:LYFORD-PIKE, SOFIA (MD,)
Entity Type:Individual
Prefix:
First Name:SOFIA
Middle Name:
Last Name:LYFORD-PIKE
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 1:7373 FRANCE AVE S STE 410
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4538
Mailing Address - Country:US
Mailing Address - Phone:952-844-0404
Mailing Address - Fax:
Practice Address - Street 1:7373 FRANCE AVE S STE 410
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4538
Practice Address - Country:US
Practice Address - Phone:952-844-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20335207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology