Provider Demographics
NPI:1891976908
Name:SODEN, CYLBURN EARL JR (MD, MA)
Entity Type:Individual
Prefix:DR
First Name:CYLBURN
Middle Name:EARL
Last Name:SODEN
Suffix:JR
Gender:M
Credentials:MD, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13920 BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5009
Mailing Address - Country:US
Mailing Address - Phone:301-776-1094
Mailing Address - Fax:301-776-0456
Practice Address - Street 1:13920 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5009
Practice Address - Country:US
Practice Address - Phone:301-776-1094
Practice Address - Fax:301-776-0456
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0020522207ND0101X
GA64075207ND0101X
CAA95934207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery