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Individual

DR. AI SAKONJU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
100 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 587-7575
(801) 662-5696
Mailing address
SUNY UPSTATE MEDICAL UNIVERSITY, 750 EAST ADAMS STREET, DEPT. OF NEUROLOGY, SYRACUSE, NY 13210
(315) 464-5302
(315) 464-7328

Taxonomy

Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
P17236
MD

Other

Enumeration date
01/19/2007
Last updated
08/07/2017
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