Provider Demographics
NPI:1912064247
Name:SOKOLOFF, MITCHELL HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:MITCHELL
Middle Name:HOWARD
Last Name:SOKOLOFF
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:UMASS MEMORIAL MEDICAL GROUP, INC.
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:800-225-8885
Mailing Address - Fax:508-334-1977
Practice Address - Street 1:33 KENDALL ST
Practice Address - Street 2:UMASS MEMORIAL MEDICAL GROUP, INC.
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2726
Practice Address - Country:US
Practice Address - Phone:508-334-8765
Practice Address - Fax:508-334-5733
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2020-10-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA258653208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110100211AMedicaid
MA110100211AMedicaid