Provider Demographics
NPI:1073558151
Name:SOUDAH, TRUMAN FARAH (MD)
Entity type:Individual
Prefix:DR
First Name:TRUMAN
Middle Name:FARAH
Last Name:SOUDAH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:8813 WALTHAM WOODS RD
Mailing Address - Street 2:STE 101 MEDICAL PRACTICE OF OB GYN
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-2402
Mailing Address - Country:US
Mailing Address - Phone:410-661-8690
Mailing Address - Fax:410-661-4416
Practice Address - Street 1:8813 WALTHAM WOODS RD
Practice Address - Street 2:STE 101
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-2402
Practice Address - Country:US
Practice Address - Phone:410-661-8690
Practice Address - Fax:410-661-4416
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MDD0018966207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDA80351Medicare UPIN