Milton D Soderberg MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

MS026190 Issued in MI

Legal business name

MILTON D SODERBERG MD

Practice address

1414 W Fair Ave Ste 109
Marquette, MI 49855-5404

Phone

(906) 225-3939

Fax

(906) 225-7488

NPI assigned

Feb 19, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Milton D Soderberg, MD

Title

Physician

Phone

(906) 225-3939

Specialties & licenses 2

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1881862324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE STE 109",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498555404",
            "telephone_number": "906-225-3939",
            "fax_number": "906-225-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE STE 109",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498555404",
            "telephone_number": "906-225-3939",
            "fax_number": "906-225-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILTON D SODERBERG MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "SODERBERG",
        "authorized_official_first_name": "MILTON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "906-225-3939",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "MS026190",
            "primary": true
        },
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MI",
            "license": "MS026190",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2025869",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Marquette, MI
• Providers in Marquette, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.