Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 045342 | CT |
N | 208000000X | Pediatrician | 045342 | CT |
NPI | 1144433723 |
---|---|
Provider Name | Michael J. Soltis |
First Address | Hartford, CT 06106-3322 |
Second Address | Hartford, CT 06106-3322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 12/12/2013 |