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Individual
MR. EDWARD F SORACE
Active
Individual
MR. EDWARD F SORACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC15
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00615
AAPA NUMBER
—
01
—
1004764
NCCPA
—
01
—
PAC15
KBML LICENSE NUMBER
KY
Enumeration date
01/23/2007
Last updated
12/03/2009
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