Provider Demographics
NPI:1093728610
Name:SOREL, ELIOT (MD)
Entity Type:Individual
Prefix:
First Name:ELIOT
Middle Name:
Last Name:SOREL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7361 CALHOUN PL
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20855-2765
Mailing Address - Country:US
Mailing Address - Phone:301-565-2250
Mailing Address - Fax:301-565-2159
Practice Address - Street 1:2301 E ST NW APT A1011
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2839
Practice Address - Country:US
Practice Address - Phone:301-565-2250
Practice Address - Fax:301-565-2159
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC102412084F0202X, 2084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCB94582Medicare UPIN
DC00A042C50Medicare PIN