Organization
GABRIEL SOUDRY MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIEL SOUDRY M.D. (PRESIDENT)
(443) 777-7492
Entity
Organization
Contact information
Practice address
9000 FRANKLIN SQUARE DR, BALTIMORE, MD 21237-3901
(443) 777-7492
Mailing address
9000 FRANKLIN SQUARE DR, BALTIMORE, MD 21237-3901
(443) 777-7492
Taxonomy
Speciality
Code
Description
License number
State
207UN0902X
Nuclear Imaging & Therapy Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0S04G
BLUE SHIELD
MD
05
—
364201100
—
MD
01
—
T390
GHI
DC
Enumeration date
12/29/2006
Last updated
01/09/2008
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