Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 4301054820 | MI |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 4301054820 | MI |
NPI | 1225075393 |
---|---|
Provider Name | Yoram Sorokin |
First Address | Troy, MI 48083-1189 |
Second Address | Detroit, MI 48201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 02/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
440701010 | (05) | MI |
700H262210 | BLUE CROSS-BLUE CROSS (01) | |
A79405 | (02) | |
YS054820 | CHAMPUS-CHAMPUS (01) | |
YS054820 | COMMERCIAL-COMMERCIAL NUMBER (01) |