Provider Demographics
NPI:1023308236
Name:SOOD, ADITYA (MD, MBA)
Entity type:Individual
Prefix:DR
First Name:ADITYA
Middle Name:
Last Name:SOOD
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 570
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1579
Mailing Address - Country:US
Mailing Address - Phone:614-293-8566
Mailing Address - Fax:614-293-3381
Practice Address - Street 1:915 OLENTANGY RIVER RD STE 2140
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3153
Practice Address - Country:US
Practice Address - Phone:614-293-8566
Practice Address - Fax:614-293-3381
Is Sole Proprietor?:No
Enumeration Date:2011-04-10
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35131598208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery