Basic Information
| Provider Information | |||||||||
| NPI: | 1023010915 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SONTCHI | ||||||||
| FirstName: | SHARI | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 660 BEAVER CREEK CIR | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | MAUMEE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435371745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4198916221 | ||||||||
| FaxNumber: | 4198933394 | ||||||||
| Practice Location | |||||||||
| Address1: | 660 BEAVER CREEK CIR | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | MAUMEE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435371745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4198916221 | ||||||||
| FaxNumber: | 4198933394 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 35063376 | OH | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 01365 | 01 | OH | PARAMOUNT | OTHER | 000000141196 | 01 | OH | ANTHEM | OTHER | 0891601 | 05 | OH | MEDICAID | 12-01180 | 01 | OH | UHC | OTHER | 0635241 | 01 | OH | AETNA | OTHER |