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Individual
MARNIE A SOSNOVSKY
Active
Individual
MARNIE A SOSNOVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002535
GA
363AM0700X
Medical Physician Assistant
002535
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10038153
AMERIGROUP
GA
01
—
11100
BLUE CROSS BLUE SHIELD
GA
01
—
333584
WELLCARE
GA
05
—
771879398
—
GA
05
—
771879398A
—
GA
05
—
771879398B
—
GA
Enumeration date
05/17/2006
Last updated
11/13/2008
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