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NPI Code Detail

MEDICARE: DR. MICHELLE A SOTO MD

MEDICARE: DR. MICHELLE A SOTO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD23927OR
2207Q00000XFamily Medicine Physician51829WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396731410
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHELLE A SOTO MD
Provider Business Mailing Address
First Line : PO BOX 8003
Second Line :
City : APPLETON
State : WI
Zip : 54912-8003
Country : US
Telephone Number : 920-996-3200
Fax Number : 920-738-5787
Provider Business Practice Location Address
First Line : 710 RIVERSIDE DR
Second Line :
City : WAUPACA
State : WI
Zip : 54981-1941
Country : US
Telephone Number : 715-256-3000
Fax Number : 715-256-3039
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2005
Last Update Date : 03/07/2023

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Directions to “ DR. MICHELLE A SOTO MD” Practice Location

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