Individual
ILO SOOVERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10 N GREENE ST, BALTIMORE, MD 21201-1524
(410) 605-7000
Mailing address
308 KESTREL DR, BELCAMP, MD 21017-1709
(410) 273-7325
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME 72452
FL
2084P0800X
Psychiatry Physician
ME 72452
FL
Other
Enumeration date
10/05/2006
Last updated
09/11/2025
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