Healthcare Provider Details

I. General information

NPI: 1285742841
Provider Name (Legal Business Name): WENDY SOTO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 UNIVERSITY BLVD
HAMILTON OH
45011-3315
US

IV. Provider business mailing address

1430 UNIVERSITY BLVD
HAMILTON OH
45011-3315
US

V. Phone/Fax

Practice location:
  • Phone: 513-896-3456
  • Fax: 513-785-4495
Mailing address:
  • Phone: 513-896-3456
  • Fax: 513-785-4495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.086079
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.086079
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: