Individual
SONIA RAE KRENGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
919 MAIN ST STE 201, DYER, IN 46311-3717
(219) 922-3002
(219) 922-3003
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
008301
GA
363A00000X
Physician Assistant
Primary
10002345A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300007352
—
IN
Enumeration date
05/05/2017
Last updated
05/25/2023
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