Healthcare Provider Details

I. General information

NPI: 1356801542
Provider Name (Legal Business Name): BRIAN SCOTT SOHL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 08/24/2023
Certification Date: 08/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 W 24TH ST STE 305
ERIE PA
16502-2666
US

IV. Provider business mailing address

780 ROBISON RD W
ERIE PA
16509-5432
US

V. Phone/Fax

Practice location:
  • Phone: 814-454-4484
  • Fax:
Mailing address:
  • Phone: 814-528-7746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD482338
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: