Provider Demographics
NPI:1366705147
Name:SORICH, MEGAN MARIE (DO)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:SORICH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8170 33RD AVE
Mailing Address - Street 2:MS 21110Q
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:651-254-8300
Mailing Address - Fax:651-254-8379
Practice Address - Street 1:435 PHALEN BLVD
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55130
Practice Address - Country:US
Practice Address - Phone:651-254-8300
Practice Address - Fax:651-254-8379
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
MN63573207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program