Provider Demographics
NPI:1174936595
Name:DEWAN, SONAL (DO)
Entity type:Individual
Prefix:DR
First Name:SONAL
Middle Name:
Last Name:DEWAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4262 OLD WILLIAM PENN HWY STE 208
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-1954
Mailing Address - Country:US
Mailing Address - Phone:724-325-2133
Mailing Address - Fax:724-733-2278
Practice Address - Street 1:4262 OLD WILLIAM PENN HWY STE 208
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1954
Practice Address - Country:US
Practice Address - Phone:724-325-2133
Practice Address - Fax:724-733-2278
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS018793208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics