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General NPI Number Information
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NPI Number | 1689686693
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Entity Type | Organization
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Legal Business Name | TRUMAN F SOUDAH,MD
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8813 WALTHAM WOODS RD.
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City | BALTIMORE
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State | MD
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Zip | 21234
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Country | US
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Telephone | 410-661-8690
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Fax | 410-661-4416
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Provider Business Mailing Address
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Address Line | 8813 WALTHAM WOODS RD.
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City | BALTIMORE
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State | MD
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Zip | 21234
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Country | US
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Telephone | 410-661-8690
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Fax | 410-661-4416
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Authorized Official
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Title or Position | OWNER
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Name | DR. TRUMAN FARAH SOUDAH
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Credential | OB,GYN
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Telephone | 410-661-8690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0018966
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License Number State | MD
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