Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 35026931 | OH |
NPI | 1003897109 |
---|---|
Provider Name | Juan Fernandez Sotos |
First Address | Columbus, OH 43205-2696 |
Second Address | Columbus, OH 43205-2696 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2005 |
Last Update Date | 26/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64761125 | (05) | KY |
8288759 | (05) | OH |
C00668 | (02) |