Provider Demographics
NPI:1861496432
Name:SONEGO, DAVID F (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:F
Last Name:SONEGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:230 E DAY RD
Mailing Address - Street 2:# 160
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-3463
Mailing Address - Country:US
Mailing Address - Phone:574-271-8222
Mailing Address - Fax:574-271-8896
Practice Address - Street 1:230 E DAY RD
Practice Address - Street 2:# 160
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-3463
Practice Address - Country:US
Practice Address - Phone:574-271-8222
Practice Address - Fax:574-271-8896
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01038008A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN01038008AOtherPHYSICIAN
IN000000184571OtherBLUE CROSS BLUE SHIELD