Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 5601008379 | MI |
N | 207R00000X | Internist | 5601008379 | MI |
N | 111NI0900X | Internist | 5601008379 | MI |
N | 207RP1001X | Pulmonary Disease | 5601008379 | MI |
NPI | 1033637244 |
---|---|
Provider Name | Joanna Soltis |
First Address | Hillsdale, MI 49242-9458 |
Second Address | Okemos, MI 48864-6036 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2017 |
Last Update Date | 12/02/2021 |