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Individual

SONNEPAL VENKAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1080 N ELLINGTON PKWY, LEWISBURG, TN 37091-2227
(904) 805-1300
(904) 805-1302
Mailing address
PO BOX 532734, ATLANTA, GA 30353-2734
(904) 805-1300
(904) 805-1302

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD28089
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3831170
TN
01
4060230
BLUE CROSS
TN
01
P00051319
RAILROAD MEDICARE
TN
01
P00051319
RAILROAD MCR
Enumeration date
05/31/2006
Last updated
01/16/2008
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