Individual
DR. SUSAN G SOTO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
18901 LAKE SHORE BLVD, EUCLID, OH 44119-1078
(216) 531-9000
Mailing address
PO BOX 74253, CLEVELAND, OH 44194-0002
(440) 879-0081
(440) 879-0084
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
35-047952
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000190381
ANTHEM
OH
05
—
0701771
—
OH
01
—
P00058199
RAILROAD MEDICARE
OH
Enumeration date
10/17/2005
Last updated
07/08/2007
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