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Individual

MR. VIJAY SOPREY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
560L LOCH RAVEN BLVD, GSH POB 406, DEPT PM & REHAB, BALTIMORE, MD 21239
(410) 532-4701
(410) 532-4719
Mailing address
560L LOCH RAVEN BLVD, GSH POB 406, DEPT PM & REHAB, BALTIMORE, MD 21239
(410) 532-4701
(410) 532-4719

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
961845
MD
363AM0700X
Medical Physician Assistant
Primary
D70201
MD

Other

Enumeration date
08/28/2007
Last updated
05/19/2010
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