Provider Demographics
NPI:1023645611
Name:SOTER, JOHN NICHOLAS (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:NICHOLAS
Last Name:SOTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:625 S NEW BALLAS RD STE 7020
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8218
Mailing Address - Country:US
Mailing Address - Phone:314-251-6486
Mailing Address - Fax:314-251-4155
Practice Address - Street 1:727 E PEAK VIEW CIR
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-8934
Practice Address - Country:US
Practice Address - Phone:801-231-4289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-24
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY57296207R00000X
KYIP1668207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine