Provider Demographics
NPI:1598879181
Name:SOOD, ARCHANA (MD)
Entity Type:Individual
Prefix:
First Name:ARCHANA
Middle Name:
Last Name:SOOD
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 1:1208 E CHURCHVILLE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3442
Mailing Address - Country:US
Mailing Address - Phone:410-399-9911
Mailing Address - Fax:410-399-4099
Practice Address - Street 1:1208 E CHURCHVILLE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3442
Practice Address - Country:US
Practice Address - Phone:410-399-9911
Practice Address - Fax:410-399-4099
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0041080173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF7570001OtherCAREFIRST
MD448591200Medicaid
MD798502900Medicaid
MDKAV5S0OtherCAREFIRST
MD448591200Medicaid
MDF7570001OtherCAREFIRST
F60773Medicare UPIN