Individual
DR. CLIFFORD J SONDGERATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3005 GREENBUSH ST, LAFAYETTE, IN 47904-2435
(765) 447-3103
(765) 449-4782
Mailing address
3005 GREENBUSH ST, LAFAYETTE, IN 47904-2435
(765) 447-3103
(765) 449-4782
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01024827A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000375908
ANTHEM PROVIDER NUMBER
IN
05
—
100230910A
—
IN
Enumeration date
09/13/2005
Last updated
10/26/2010
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