Provider Demographics
NPI:1891806238
Name:GUERRA, SONIA (MD)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:
Last Name:GUERRA
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 1:6005 PARK AVE STE 902
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-5219
Mailing Address - Country:US
Mailing Address - Phone:901-821-0025
Mailing Address - Fax:901-821-9509
Practice Address - Street 1:6005 PARK AVE STE 902
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5219
Practice Address - Country:US
Practice Address - Phone:901-821-0025
Practice Address - Fax:901-821-9509
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3700157207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN000000116930OtherUNISON HEALTHCARE
TN3083520OtherBLUECROSS BLUESHEILD TN
TN3340016OtherUNITED HEALTHCARE
TN3370566Medicaid
TNF62736Medicare UPIN
TN3370566Medicaid