Provider Demographics
NPI:1174592885
Name:SONEK, MOJMIR J (MD)
Entity type:Individual
Prefix:
First Name:MOJMIR
Middle Name:J
Last Name:SONEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1301 TAYLOR ST
Mailing Address - Street 2:STE 4K
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2942
Mailing Address - Country:US
Mailing Address - Phone:803-254-7004
Mailing Address - Fax:803-254-7057
Practice Address - Street 1:1301 TAYLOR ST
Practice Address - Street 2:STE 4K
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2942
Practice Address - Country:US
Practice Address - Phone:803-254-7004
Practice Address - Fax:803-254-7057
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2016-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC15829207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP0691Medicaid
SC4863Medicare PIN
C81818Medicare UPIN