Provider Demographics
NPI:1740226877
Name:SOOD, VIVEK (MD)
Entity Type:Individual
Prefix:
First Name:VIVEK
Middle Name:
Last Name:SOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1300 RITCHIE HIGHWAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012
Mailing Address - Country:US
Mailing Address - Phone:410-544-4855
Mailing Address - Fax:410-315-9150
Practice Address - Street 1:1300 RITCHIE HIGHWAY
Practice Address - Street 2:SUITE A
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012
Practice Address - Country:US
Practice Address - Phone:410-544-4855
Practice Address - Fax:410-315-9150
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2020-06-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD67449207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6782329OtherAETNA HMO
MD8053792OtherCIGNA
MD7273666OtherAETNA PPO
MD223468OtherJHHC
MD930539-01OtherCAREFIRST
MD417274400Medicaid
MDP00669499OtherRAILROAD
MD417274400Medicaid
MDP00669499OtherRAILROAD