Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 34.003601 | OH |
N | 207Q00000X | Family Doctor | 34003601 | OH |
NPI | 1598713505 |
---|---|
Provider Name | Dr. Michael D Soroka |
First Address | Dublin, OH 43016-4141 |
Second Address | Belpre, OH 45714-1075 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 17/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E71633 | (02) | |
E71633 | (02) | OH |