Healthcare Provider Details

I. General information

NPI: 1952453615
Provider Name (Legal Business Name): MARIA B. SOTO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 OLD NORCROSS RD STE A
LAWRENCEVILLE GA
30046-4315
US

IV. Provider business mailing address

603 OLD NORCROSS RD STE A
LAWRENCEVILLE GA
30046-4315
US

V. Phone/Fax

Practice location:
  • Phone: 678-407-4489
  • Fax:
Mailing address:
  • Phone: 678-407-4489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number93913
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: