MEDICARE: MICHAEL W SOEHNLEN 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
1	2085R0202X	Diagnostic Radiology Physician	MD421874	PA
2	2085B0100X	Body Imaging Physician	35 087482	OH
3	2085R0202X	Diagnostic Radiology Physician	35087482	OH
4	2085N0700X	Neuroradiology Physician	35087482	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00407450	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00971839	OTHER	OH	RXR MCR
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700885142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL W SOEHNLEN MD

Provider Business Mailing Address
First Line	:	P.O. BOX 72384
Second Line	:	RADIOLOGY ASSOCIATES OF CANTON, INC.
City	:	CLEVELAND
State	:	OH
Zip	:	44192
Country	:	US
Telephone Number	:	888-686-1837
Fax Number	:	330-686-5928

Provider Business Practice Location Address
First Line	:	2600 6TH ST SW
Second Line	:	RADIOLOGY ASSOCIATES OF CANTON, INC.
City	:	CANTON
State	:	OH
Zip	:	44710-1702
Country	:	US
Telephone Number	:	330-363-2842
Fax Number	:	330-580-5536

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	02/15/2012

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