MEDICARE: DR. LESLEY A SOINE 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	207Y00000X	Otolaryngology Physician	10000	ND

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700944915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESLEY A SOINE MD

Provider Business Mailing Address
First Line	:	350 23RD AVE E STE 102
Second Line	:
City	:	WEST FARGO
State	:	ND
Zip	:	58078-7401
Country	:	US
Telephone Number	:	701-235-1924
Fax Number	:	701-235-6304

Provider Business Practice Location Address
First Line	:	350 23RD AVE E STE 102
Second Line	:
City	:	WEST FARGO
State	:	ND
Zip	:	58078-7401
Country	:	US
Telephone Number	:	701-235-1924
Fax Number	:	701-235-6304

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

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	01/03/2024

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