Provider Demographics
NPI:1013010545
Name:RICHMOND, SONJA (MD)
Entity Type:Individual
Prefix:DR
First Name:SONJA
Middle Name:
Last Name:RICHMOND
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 1:12118 CHANCERY STATION CIR
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5800
Mailing Address - Country:US
Mailing Address - Phone:301-917-2933
Mailing Address - Fax:
Practice Address - Street 1:12118 CHANCERY STATION CIR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5800
Practice Address - Country:US
Practice Address - Phone:301-917-2933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2017-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0062885207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine