Provider Demographics
NPI:1255385654
Name:SONIN, ANDREW (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:SONIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 E GEDDES AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3895
Mailing Address - Country:US
Mailing Address - Phone:303-761-9190
Mailing Address - Fax:720-874-4462
Practice Address - Street 1:8200 E BELLEVIEW AVE
Practice Address - Street 2:NO 124
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2803
Practice Address - Country:US
Practice Address - Phone:303-761-9190
Practice Address - Fax:720-874-4462
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2024-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-297732085R0202X
NE225812085R0202X
OK310382085R0202X
HIMD175922085R0202X
CO395512085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1255385654Medicaid
SD1255385654/7729210Medicaid
CO300127414OtherRR MIC MCRE
NM37375857Medicaid
SCQ39551Medicaid
MI104686374Medicaid
HI0000343814OtherHMSA ALL PRODUCTS
KS200379590AMedicaid
WY1255385654Medicaid
WA0180111OtherSTATE OF WA DEPT LABOR AND INDUSTRIES
NE10025709000Medicaid
OH1255385654Medicaid
MO200125102Medicaid
CO300127412OtherRR RIA MCRE
CO44402023Medicaid
NY02567595Medicaid
WA0292670OtherSTATE OF WA, DEPT OF LABOR AND INDUSTRIES
NE84-059792913Medicaid
AZ922577Medicaid
SCQ39551Medicaid
COC444838Medicare PIN
COC444868Medicare PIN
CO392366ZLJ3Medicare PIN
HIH105444Medicare PIN
COC444848Medicare PIN
NENA1215008Medicare PIN
WA0292670OtherSTATE OF WA, DEPT OF LABOR AND INDUSTRIES
KS200379590AMedicaid
KSKA3249039Medicare PIN
KS111257039Medicare PIN
WA0180111OtherSTATE OF WA DEPT LABOR AND INDUSTRIES
NV1255385654Medicaid