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Individual

SUSHILKUMAR KADU SONAVANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
(205) 297-9411

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2010007603
MO
2085R0202X
Diagnostic Radiology Physician
L.3416SP
AL
2085R0202X
Diagnostic Radiology Physician
Primary
ME139396
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051117667
BCBS
AL
01
051117668
BCBS
AL
01
051117669
BCBS
AL
01
051117671
BCBS
AL
01
051117672
BCBS
AL
01
051117673
BCBS
AL
01
051117674
BCBS
AL
01
051117676
BCBS
AL
01
051117678
BCBS
AL
01
051117679
BCBS
AL
05
07135395
MS
05
129724
AL
05
129728
AL
05
129730
AL
05
129732
AL
05
129734
AL
05
129738
AL
05
129743
AL
05
129746
AL
05
129750
AL
05
129751
AL
Enumeration date
06/11/2007
Last updated
09/02/2020
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