Provider Demographics
NPI:1245224575
Name:SOBER, JULIAN NEAL (DPM)
Entity Type:Individual
Prefix:DR
First Name:JULIAN
Middle Name:NEAL
Last Name:SOBER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 CRAIN HWY S
Mailing Address - Street 2:SUITE #2
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-3657
Mailing Address - Country:US
Mailing Address - Phone:410-768-4300
Mailing Address - Fax:410-768-4301
Practice Address - Street 1:420 CRAIN HWY S
Practice Address - Street 2:SUITE #2
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3657
Practice Address - Country:US
Practice Address - Phone:410-768-4300
Practice Address - Fax:410-768-4301
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-01
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD256213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDT-135OtherMEDICARE AND CAREFIRST