Physician Compare National (NPI:1285617506)

HEALTHCARE PROVIDER: JEFFREY SOULEN M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1285617506
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4183890445
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120109000336
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SOULEN
	Individual professional last name
Provider First Name	JEFFREY
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PERELMAN SCHOOL OF MED AT THE UNIVERSITY OF PENNSYLVANIA
	Individual professional's medical school
Graduation Year	1984
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3355 SAINT JOHNS LN F
	Group Practice or individual's line 1 address
City	ELLICOTT CITY
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	210422600
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4104652056
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M