Sonali Nitin Wilborn, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301071894 Issued in MI

Practice address

18181 Oakwood Blvd
Ste 208
Dearborn, MI 48124-5032

Phone

(313) 271-5565

Fax

(313) 271-1053

NPI assigned

Sep 25, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 4

Other names 1

• Sonali Nitin Nayak Former name

Medicare fee-for-service enrollment

Enrolled in MI, NC, CO, FL4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290384000000",
    "number": "1164523247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 GREENFIELD RD",
            "address_2": "SUITE 250",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201802",
            "telephone_number": "313-563-3332",
            "fax_number": "313-563-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18181 OAKWOOD BLVD",
            "address_2": "STE 208",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481245032",
            "telephone_number": "313-271-5565",
            "fax_number": "313-271-1053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBORN",
        "first_name": "SONALI",
        "middle_name": "NITIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2010-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301071894",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "4301071894",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "MI",
            "license": "4301071894",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "110H243080",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1108294772",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427297712",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4535861-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONALI",
            "last_name": "NAYAK",
            "middle_name": "NITIN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David C Whitesell, CRNA
• Shantel Lorraine Whitfield
• Darnasia Whitsell
• Whole Mission LLC
• Sarah Wiese
• Delilah Wilcox, BEHAVIOR ANALYST
• Antoinette Wilder, LMSW
• Madison Wilk
• Alyson Lynn Wilkes, MA, LPC, NCC
• Samantha Kathleen Estelle Will

• Internal Medicine Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.