Sofair, Audrey Fawn
Sofair, Audrey Fawn is an sole proprietor health care provider with primary practice located at 11123 Parkview Plaza Dr Ste 201 , Fort Wayne IN 46845-1707. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Rehabilitation Medicine, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is her primary health care specialty. Sofair, Audrey Fawn can be contacted via phone (260) 425-5950.Contact Information
Primary practice address
11123 Parkview Plaza Dr Ste 201
Fort Wayne IN 46845-1707
Phone: (260) 425-5950
Fax: (260) 425-5165
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatric Rehabilitation Medicine | 2081P0010X | 194228 | New York |
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 01082071A | Indiana |
Profile Details
NPI number | 1326139833 |
---|---|
LBN Legal business name | Sofair, Audrey Fawn |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Sep 28th, 2006 |
Last updated | Mar 2nd, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1326139833 | NPPES |
New York | MEDICAID | 01888426 |
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