Basic Information
Provider Information
NPI: 1164641478
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DHINGRA
FirstName: SONIA
MiddleName: SHARMA
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3301 W FOREST HOME AVE
Address2:  
City: MILWAUKEE
State: WI
PostalCode: 532152843
CountryCode: US
TelephoneNumber: 4143892377
FaxNumber:  
Practice Location
Address1: 975 PORT WASHINGTON RD
Address2:  
City: GRAFTON
State: WI
PostalCode: 530249201
CountryCode: US
TelephoneNumber: 2623291000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/25/2007
LastUpdateDate: 11/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0200X46491WIY Allopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease

ID Information
IDTypeStateIssuerDescription
3493390005WI MEDICAID


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