Healthcare Provider Details

I. General information

NPI: 1578599429
Provider Name (Legal Business Name): MICHELLE SOTOS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 06/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 DIXMYTH AVE
CINCINNATI OH
45220-2475
US

IV. Provider business mailing address

PO BOX 636799
CINCINNATI OH
45263-6799
US

V. Phone/Fax

Practice location:
  • Phone: 513-862-3452
  • Fax: 513-862-3421
Mailing address:
  • Phone: 513-862-3452
  • Fax: 513-862-3421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35083117
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: