Individual
MANUEL SOTO-FOURNIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7253 AMBASSADOR RD, BALTIMORE, MD 21244
(443) 436-1221
(443) 436-1256
Mailing address
7253 AMBASSADOR RD, BALTIMORE, MD 21244-2710
(443) 436-1221
(443) 436-1256
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
D83030
MD
2085R0202X
Diagnostic Radiology Physician
Primary
D0083030
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
211243400
—
MD
Enumeration date
03/30/2012
Last updated
07/16/2019
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