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General NPI Number Information
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NPI Number | 1700077054
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Entity Type | Individual
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Provider Name | EKATERINA V SOFORO M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/01/2007
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 1414 N TAYLOR DR STE 110
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City | SHEBOYGAN
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State | WI
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Zip | 53081-3090
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Country | US
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Telephone | 920-320-5241
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Fax |
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Provider Business Mailing Address
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Address Line | 3 NEENAH CTR
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City | NEENAH
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State | WI
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Zip | 54956-3070
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Country | US
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Telephone | 920-830-5900
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Fax | 920-830-5910
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 52056-20
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License Number State | WI
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