Provider Demographics
NPI:1083601199
Name:SOLL, DAVID J (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:SOLL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 70TH AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-4632
Mailing Address - Country:US
Mailing Address - Phone:970-810-3550
Mailing Address - Fax:731-422-2277
Practice Address - Street 1:2001 70TH AVE STE 300
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-4632
Practice Address - Country:US
Practice Address - Phone:970-810-3550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37015207V00000X
CO69678207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4050211OtherBCBS OF TN
TN4609436OtherCIGNA
TN3880342Medicaid
TN5835646OtherAETNA
TN3880342Medicaid
TN4050211OtherBCBS OF TN