Individual
SONIA G FERNANDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14555 LEVAN RD, SUITE 312, LIVONIA, MI 48154-5083
(734) 542-7190
(734) 542-7192
Mailing address
14555 LEVAN RD, SUITE 312, LIVONIA, MI 48154-5083
(734) 542-7190
(734) 542-7192
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
SF047286
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110229
PREFERRED CHOICE
MI
01
—
130002187
RAILROAD MEDICARE
MI
01
—
1308246641
BLUE CROSS BLUE SHIELD MI
MI
05
—
171667
—
MI
Enumeration date
10/16/2006
Last updated
06/23/2009
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