Individual
DR. GERARDO L. SOTOMAYOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3957 HOLCOMB BRIDGE RD, SUITE 100, NORCROSS, GA 30092-5254
(770) 939-5102
(770) 938-9323
Mailing address
3957 HOLCOMB BRIDGE RD, SUITE 100, NORCROSS, GA 30092-5254
(770) 939-5102
(770) 938-9323
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
026184
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00526512A
—
GA
01
—
0511749
AETNA
GA
01
—
0700202
UHC
GA
01
—
170000129
MEDICARE R.R.
GA
01
—
4509386
AETNA MC
GA
01
—
681004
BLUE CROSS
GA
Enumeration date
09/26/2006
Last updated
06/28/2016
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