Individual
CARLOS BIENVENIDO SORIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
350 HUNTINGTON PLACE COURT, MCDONOUGH, GA 30253
(770) 957-3393
(770) 957-4902
Mailing address
PO BOX 1720, MCDONOUGH, GA 30253
(770) 957-3393
(770) 957-4902
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
048575
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00856655A
—
GA
Enumeration date
10/17/2006
Last updated
10/03/2011
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