Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 016701 | ME |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 016701 | ME |
NPI | 1104806314 |
---|---|
Provider Name | Daniel Soroff |
First Address | Lewiston, ME 04240-7616 |
Second Address | Lewiston, ME 04240-7616 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2006 |
Last Update Date | 05/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I24227 | (02) | ME |