Basic Information
Provider Information
NPI: 1124281134
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SEO-PATEL
FirstName: SONYOUNG
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SEO
OtherFirstName: SUNNY
OtherMiddleName:  
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 5
Mailing Information
Address1: 2150 W CENTRAL AVE
Address2:  
City: TOLEDO
State: OH
PostalCode: 436063834
CountryCode: US
TelephoneNumber: 4192912192
FaxNumber: 4194793297
Practice Location
Address1: 2150 W CENTRAL AVE
Address2:  
City: TOLEDO
State: OH
PostalCode: 436063834
CountryCode: US
TelephoneNumber: 4192912192
FaxNumber: 4194793297
Other Information
ProviderEnumerationDate: 07/09/2008
LastUpdateDate: 09/22/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XMD446590PAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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