Provider Demographics
NPI:1295994176
Name:SOLOMON, SONIA MANNAN (MD)
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:MANNAN
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SONIA
Other - Middle Name:
Other - Last Name:MANNAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 12622
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4017
Mailing Address - Country:US
Mailing Address - Phone:443-481-6569
Mailing Address - Fax:443-481-6515
Practice Address - Street 1:2001 MEDICAL PARKWAY
Practice Address - Street 2:ACUTE CARE PAVILION
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3280
Practice Address - Country:US
Practice Address - Phone:443-481-1000
Practice Address - Fax:443-481-1687
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0069927208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
607156012OtherDEPT OF LABOR
MD418896900Medicaid
V8260029OtherCAREFIRST
95836303OtherCAREFIRST
MD418896900Medicaid
169208Y5ZMedicare PIN