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Individual

DR. MARK STEVEN SOUDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1310 E 7TH ST, AUBURN, IN 46706-2534
(260) 925-0305
(260) 925-6041
Mailing address
1310 E 7TH ST, AUBURN, IN 46706-2534
(260) 925-0305
(260) 925-6041

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01026373A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000083986
BCBS
01
081664279
RR MEDICARE
05
100053210A
IN
Enumeration date
01/03/2006
Last updated
10/01/2008
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