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Individual

ADAM DAVID SOUCHIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2160 S 1ST AVE, FAHEY BLDG./ROOM 101, MAYWOOD, IL 60153-3328
(708) 216-4962
(708) 216-2444
Mailing address
1475 GRANARY RD, BLUE BELL, PA 19422-2155

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
125077603
IL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/27/2020
Last updated
06/21/2021
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