Provider Demographics
NPI:1265699243
Name:BAINS, SONIA NOREEN (MD)
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:NOREEN
Last Name:BAINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SONIA
Other - Middle Name:NOREEN
Other - Last Name:ALAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 603725
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3725
Mailing Address - Country:US
Mailing Address - Phone:828-575-2625
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:10880 DURANT RD STE 200
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-6629
Practice Address - Country:US
Practice Address - Phone:919-846-0880
Practice Address - Fax:919-846-0880
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-02520207K00000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1265699243Medicaid
NCNCL942BOtherMEDICARE PTAN