Healthcare Provider Details

I. General information

NPI: 1023001484
Provider Name (Legal Business Name): SOENDA P NORMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SOENDA E PADMORE MD

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 12/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10211 ALM ST SUITE 1200
RALEIGH NC
27617-8221
US

IV. Provider business mailing address

5213 S ALSTON AVE
DURHAM NC
27713-4430
US

V. Phone/Fax

Practice location:
  • Phone: 919-206-4889
  • Fax: 919-206-4875
Mailing address:
  • Phone:
  • Fax: 919-620-4921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD11651
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2012-01463
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: