Provider Demographics
NPI:1881815801
Name:SONONE, RAHUL VASANT (MD)
Entity Type:Individual
Prefix:DR
First Name:RAHUL
Middle Name:VASANT
Last Name:SONONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7645 WOLF RIVER CIR
Mailing Address - Street 2:100
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1751
Mailing Address - Country:US
Mailing Address - Phone:901-405-0275
Mailing Address - Fax:
Practice Address - Street 1:7645 WOLFRIVER CIRCLE
Practice Address - Street 2:100
Practice Address - City:GERMATOWN
Practice Address - State:TN
Practice Address - Zip Code:38135
Practice Address - Country:US
Practice Address - Phone:901-405-0275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN436402084N0400X
MS202422084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1510061Medicaid
MS07200539Medicaid