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Contact Information

RICHARD SO, MD
20800 WESTGATE MALL
SUITE 400
FAIRVIEW PARK, OH44126-1323
 Phone: 440-356-2272
 Fax: 440-356-2299
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Sports Medicine

207RS0010X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for RICHARD SO · (Male)

NPI # 1962428557
Status Active
Credentials MD
Entity Individual
Enumeration date 07/15/2006
Last updated 01/10/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • OH License # 35090551
  • OH Medicaid 2780745
  • OH Other 000000536776 ANTHEM BC/BS
  • OH Other 340714618243 CARESOURCE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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