Provider Demographics
NPI:1598937070
Name:SOONDAR, STEPHEN S (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:S
Last Name:SOONDAR
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 1:101 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-3037
Mailing Address - Country:US
Mailing Address - Phone:610-565-3668
Mailing Address - Fax:610-565-9722
Practice Address - Street 1:101 N MONROE ST
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-3037
Practice Address - Country:US
Practice Address - Phone:610-565-3668
Practice Address - Fax:610-565-9722
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005861213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist