# JEREMY B SOULE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1467560326
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 19264 | WV | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 20980 | SC | — |

## Other

- **Enumeration date:** 08/29/2006
- **Last updated:** 04/06/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 209802 | — | SC |