Individual
ALIN SORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
64840
WI
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
AS0788771
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080Z71003-0
BLUE CROSS
MI
01
—
238646
RHC MEDICARE
MI
05
—
4421010
—
MI
Enumeration date
07/23/2006
Last updated
02/08/2016
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