Provider Demographics
NPI:1700944915
Name:SOINE, LESLEY A (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLEY
Middle Name:A
Last Name:SOINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:350 23RD AVE E STE 102
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-7401
Mailing Address - Country:US
Mailing Address - Phone:701-235-1924
Mailing Address - Fax:701-235-6304
Practice Address - Street 1:350 23RD AVE E STE 102
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-7401
Practice Address - Country:US
Practice Address - Phone:701-235-1924
Practice Address - Fax:701-235-6304
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND10000207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND13517Medicaid
MN040000779Medicare PIN
NDN711499Medicare PIN
ND13517Medicaid