| Doctor Name: | MRS. SOLFIA MEDINA SAULOG |
| NPI Number: | 1437322823 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | |
| Business Practice Address: | 1800 E Lake Shore Dr Decatur, IL - 625213810 |
| Business Phone Number: | 2174642870 |
| Business Fax Number: | 2174641616 |
| Mailing Address: | 4075 Copper Ridge Dr, TRAVERSE CITY |
| State: | MI |
| Postal Code: | 496847059 |
| Phone Number: | 8886320543 |
| Fax Number: | 2319324204 |
| NPI Enumeration Date: | 04/08/2008 |
| NPI Last Update Date: | 04/08/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |