Provider Demographics
NPI:1881803641
Name:SOOD, AJAY (MD)
Entity type:Individual
Prefix:
First Name:AJAY
Middle Name:
Last Name:SOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 SAINT MARGARET ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-3678
Mailing Address - Country:US
Mailing Address - Phone:843-469-1608
Mailing Address - Fax:888-258-1421
Practice Address - Street 1:255 KING ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-1435
Practice Address - Country:US
Practice Address - Phone:843-469-1608
Practice Address - Fax:888-258-1421
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC302032084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry