Individual
DR. DAVID PHILLIP SONNENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
230 E DAY RD STE 100, MISHAWAKA, IN 46545-3408
(574) 271-3939
(574) 271-3941
Mailing address
230 E DAY RD, STE 100, MISHAWAKA, IN 46545-3408
(574) 271-3939
(574) 271-3941
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046010413
IL
152W00000X
Optometrist
Primary
18003642
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201113290
—
IN
01
—
2044600006
PTAN
IN
01
—
P01171205
MEDICARE RAILROAD
IN
Enumeration date
08/10/2010
Last updated
07/21/2022
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