Provider Demographics
NPI:1265614168
Name:SORACE, MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:SORACE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:745 W SAN ANTONIO AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-3213
Mailing Address - Country:US
Mailing Address - Phone:210-236-9372
Mailing Address - Fax:210-251-3237
Practice Address - Street 1:745 W SAN ANTONIO AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-3213
Practice Address - Country:US
Practice Address - Phone:210-236-9372
Practice Address - Fax:210-251-3237
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2016-02-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXN3322207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery