Provider Demographics
NPI:1013252121
Name:CHRISTIAN A. SONNEFELD, MD, PLLC
Entity Type:Organization
Organization Name:CHRISTIAN A. SONNEFELD, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SONNEFELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-231-8049
Mailing Address - Street 1:76 16TH ST
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-3660
Mailing Address - Country:US
Mailing Address - Phone:304-233-3400
Mailing Address - Fax:304-233-6945
Practice Address - Street 1:76 16TH ST
Practice Address - Street 2:SUITE 100A
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3660
Practice Address - Country:US
Practice Address - Phone:304-233-3400
Practice Address - Fax:304-233-6945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV221062084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810008878Medicaid
WV4214911Medicare PIN