Provider Demographics
NPI:1053524272
Name:SOTO, CARMEN ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:ELIZABETH
Last Name:SOTO
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Gender:F
Credentials:MD
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Mailing Address - Street 1:4761 HIGBEE AVE NW
Mailing Address - Street 2:COMMUNITY HEALTH CARE
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2551
Mailing Address - Country:US
Mailing Address - Phone:330-493-0476
Mailing Address - Fax:330-493-0803
Practice Address - Street 1:4761 HIGBEE AVE NW
Practice Address - Street 2:COMMUNITY HEALTH CARE
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2551
Practice Address - Country:US
Practice Address - Phone:330-493-0476
Practice Address - Fax:330-493-0803
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2012-11-02
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Provider Licenses
StateLicense IDTaxonomies
OH35.095715207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3080384Medicaid
OHSO429951Medicare UPIN