Provider Demographics
NPI:1871978676
Name:SONI, RONAK GAJENDRAKUMAR (MD)
Entity type:Individual
Prefix:
First Name:RONAK
Middle Name:GAJENDRAKUMAR
Last Name:SONI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 WESTERN AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-4980
Mailing Address - Country:US
Mailing Address - Phone:501-358-6905
Mailing Address - Fax:501-255-6140
Practice Address - Street 1:525 WESTERN AVE STE 202
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-4980
Practice Address - Country:US
Practice Address - Phone:501-358-6905
Practice Address - Fax:501-255-6140
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-15003207RI0011X
MI4301503667207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology