Organization
CASPER PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMBROSE SOLER M.D. (OWNER)
(307) 265-2400
Entity
Organization
Contact information
Practice address
1300 E A ST, SUITE 206, CASPER, WY 82601-2260
(307) 265-2400
(307) 265-2566
Mailing address
1300 E A ST, SUITE 206, CASPER, WY 82601-2260
(307) 265-2400
(307) 265-2566
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
8373A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710915525
BCBS
WY
05
—
1710915525
—
WY
Enumeration date
06/17/2011
Last updated
06/17/2011
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