Provider Demographics
NPI:1457625584
Name:SOFFER, DIANA (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:SOFFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 STEEPLE CHASE DR STE 403
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-4051
Mailing Address - Country:US
Mailing Address - Phone:443-530-9424
Mailing Address - Fax:443-338-8238
Practice Address - Street 1:301 STEEPLE CHASE DR STE 403
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4051
Practice Address - Country:US
Practice Address - Phone:443-530-9424
Practice Address - Fax:443-338-8238
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-07
Last Update Date:2021-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA112146207V00000X
MDD74536207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology