Provider Demographics
NPI:1902037989
Name:SORIC, MATE MICHAEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:MATE
Middle Name:MICHAEL
Last Name:SORIC
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13207 RAVENNA RD
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-7032
Mailing Address - Country:US
Mailing Address - Phone:440-285-3037
Mailing Address - Fax:440-285-6369
Practice Address - Street 1:13207 RAVENNA RD
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-7032
Practice Address - Country:US
Practice Address - Phone:440-285-3037
Practice Address - Fax:440-285-6369
Is Sole Proprietor?:No
Enumeration Date:2009-08-07
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03129285183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist