Individual
DR. DOUGLAS WAYNE SODERDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3851 ROGER BROOKE DRIVE, MCHE-QD, FORT SAM HOUSTON, TX 78234-6200
(210) 916-2460
Mailing address
3851 ROGER BROOKE DRIVE, MCHE-QD, FORT SAM HOUSTON, TX 78234-6200
(210) 916-2460
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
0101233888
VA
208800000X
Urology Physician
Primary
34673-20
WI
Other
Enumeration date
12/27/2005
Last updated
05/13/2015
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