Provider Demographics
NPI:1013350206
Name:ALENCHERRY, SONIA SARA (MD)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:SARA
Last Name:ALENCHERRY
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 1:380 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2667
Mailing Address - Country:US
Mailing Address - Phone:740-283-7659
Mailing Address - Fax:740-283-7460
Practice Address - Street 1:1576 MERRITT BLVD STE 14
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-2114
Practice Address - Country:US
Practice Address - Phone:410-650-2000
Practice Address - Fax:866-639-5353
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA303175207Q00000X
OH35.132987207Q00000X
390200000X
MDD88911207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0263203Medicaid
MS03031572Medicaid
LA2328310Medicaid