Basic Information
Provider Information
NPI: 1649612722
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AULAKH
FirstName: SONIKPREET
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4500 SAN PABLO RD S
Address2:  
City: JACKSONVILLE
State: FL
PostalCode: 322241865
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1 MEDICAL CENTER DR
Address2:  
City: MORGANTOWN
State: WV
PostalCode: 265061200
CountryCode: US
TelephoneNumber: 3045984800
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/18/2013
LastUpdateDate: 04/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003X29059WVY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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