Provider Demographics
NPI:1760498992
Name:SORIANO, ALFREDO P (MD)
Entity Type:Individual
Prefix:
First Name:ALFREDO
Middle Name:P
Last Name:SORIANO
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 1:610 E LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23324
Mailing Address - Country:US
Mailing Address - Phone:757-545-3689
Mailing Address - Fax:757-545-1631
Practice Address - Street 1:610 E LIBERTY ST
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23324
Practice Address - Country:US
Practice Address - Phone:757-545-3689
Practice Address - Fax:757-545-1631
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101021414207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA027251OtherANTHEM BCBS
VA6038361Medicaid
VA027251OtherANTHEM BCBS