Provider Demographics
NPI:1447233226
Name:SORIANO, MICHELLE L (MD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:SORIANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 BOISE AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-5004
Mailing Address - Country:US
Mailing Address - Phone:970-667-2009
Mailing Address - Fax:970-667-2103
Practice Address - Street 1:1900 BOISE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-5004
Practice Address - Country:US
Practice Address - Phone:970-667-2009
Practice Address - Fax:970-667-2103
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38136207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO35731044Medicaid
COSO644240OtherANTHEM BCBS
COSO644240OtherANTHEM BCBS
CO35731044Medicaid