EKATERINA V SOFORO (NPI# 1700077054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700077054 |
| Entity Type | Individual |
| Full Name | EKATERINA V SOFORO |
| Credential | M.D. |
| Practice Address |
1650 S 41st St Manitowoc WI 54220-7316 |
| Mailing Address |
Po Box 2290 Manitowoc WI 54221-2290 |
| Practice Telephone | 9203204500 |
| Mailing Telephone | 9203202591 |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2012-07-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
52056-20 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | RR MEDICARE | P00976931 | 01 |
| WI | 207R00000X | 05 |
| Street Address |
1650 S 41ST ST |
| City | MANITOWOC |
| State | WI |
| Zip Code | 54220-7316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548260060 | Jonathan A Snellgrove | Podiatrist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2005-07-27 |
| 1700484326 | Kora Tesarik | Physical Therapy Assistant | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2020-10-15 |
| 1699386367 | Nicole Sixel | Nurse Practitioner | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2020-08-14 |
| 1891320735 | June C Magnussen | Nurse Practitioner | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2020-03-11 |
| 1063062271 | Kelly Marie Liebergen | Speech-Language Pathologist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2019-09-19 |
| 1235601709 | Kara Danielle Mcclone | Physician Assistant | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2018-12-21 |
| 1770074809 | Andrea B Zahn | Physical Therapist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2018-05-24 |
| 1790274454 | Maria E Lensmire | Physical Therapy Assistant | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2018-05-08 |
| 1053835207 | Nicole Drew | Physical Therapist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2017-07-31 |
| 1740729714 | Margaret Huebbe | Speech-Language Pathologist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2017-02-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235614843 | Katherine Borchardt | Registered Nurse | 3520 Foxfire Ct, Manitowoc, WI 54220 | 2018-09-28 |
| 1285128215 | Aurora Pharmacy Inc | Pharmacy | 3509 Dewey Street, Suite 100, Manitowoc, WI 54220 | 2018-06-22 |
| 1477937274 | Baycare Clinic LLP | Psychiatry & Neurology | 4801 Expo Drive, Manitowoc, WI 54220 | 2015-07-13 |
| 1831593821 | Brittany Camille Schultz | Acupuncturist | 2510 Washington Street, Manitowoc, WI 54220 | 2014-10-20 |
| 1710311261 | Brian E Weitz | Physical Therapy Assistant | 960 S. Rapids Rd., Manitowoc, WI 54220 | 2013-09-01 |
| 1134499080 | Total Renal Care Inc | Clinic/Center | 3303 Dewey St, Manitowoc, WI 54220 | 2012-01-10 |
| 1679858534 | Lisa M Noworatzky | Marriage & Family Therapist | 926 S. 8th St., Manitowoc, WI 54220 | 2011-10-11 |
| 1306177225 | Cynthia Fay Wenzel | Licensed Practical Nurse | 915 East Linden Avenue, Manitowoc, WI 54220 | 2010-01-15 |
| 1851550628 | Roundys Supermarkets Inc | Pharmacy | 3300 Calumet Ave, Manitowoc, WI 54220 | 2008-06-05 |
| 1851566079 | Jennifer C Mcwilliams | Registered Nurse | 1004 Nth 8th St., Manitowoc, WI 54220 | 2008-04-29 |
| Find all providers in zip 54220 | ||||
| Taxonomy Code | 207RR0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Rheumatology |
| An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336435585 | Holy Family Memorial Inc | Internal Medicine | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2011-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073755468 | Lon Allen Blaser | Internal Medicine | 3304 Evergreen Ln, Eau Claire, WI 54701-5912 | 2009-03-31 |
| 1750544193 | Walter Roach Sundstrom | Internal Medicine | 404 Orchard Dr, Madison, WI 53711-1315 | 2008-07-07 |
| 1104001098 | Lakeshore Rheumatology, LLC | Internal Medicine | 377 W Riverwoods Parkway, Suite 190, Glendale, WI 53212 | 2008-01-09 |
| 1154527455 | Rheumatology and Immunotherapy | Internal Medicine | 4225 W Oakwood Park Ct, Franklin, WI 53132-8131 | 2007-06-23 |
| 1881803658 | Robina Naz Chowdhery | Internal Medicine | 9697 Saint Catherines Dr # 400, Pleasant Prairie, WI 53158-2118 | 2007-05-21 |
| 1013125186 | Tom M Murphy | Internal Medicine | 1848 Raintree Ln, Racine, WI 53406-7638 | 2007-05-20 |
| 1134234859 | Alvin F Wells | Internal Medicine | 4225 W Oakwood Park Court, Franklin, WI 53132 | 2006-08-20 |
| 1740227669 | Indravadan Kansari | Internal Medicine | 1020 Kabel Ave, Rhinelander, WI 54501-3918 | 2006-05-31 |
| 1306890470 | Milwaukee Rheumatology Center, Sc | Internal Medicine | 2901 W Kinnickinic River Pkwy, Suite 301, Milwaukee, WI 53215-3660 | 2006-05-21 |
| 1932162658 | Allan L Goldman | Internal Medicine | 2801 W Kk River Prkwy, Suite 375, Milwaukee, WI 53215-3678 | 2006-04-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.