Healthcare Provider Details

I. General information

NPI: 1841426459
Provider Name (Legal Business Name): KARL ANTON SODERLUND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2009
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WALTER REED NATIONAL MILITARY MEDICAL CENTER 8901 WISCONSIN AVE
BETHESDA MD
20889
US

IV. Provider business mailing address

WALTER REED NATIONAL MILITARY MEDICAL CENTER 8901 WISCONSIN AVE
BETHESDA MD
20889
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-7801
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberA145800
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number0101247991
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: