Carl William Soderstrom in Peoria - Dermatology
Carl William Soderstrom - NPI 1053370759
Carl William Soderstrom is a Dermatology in Peoria, Illinois. Carl William Soderstrom practices all healthcare services and medical treatments related to Dermatology. The NPI Number for Carl William Soderstrom is 1053370759. The last update date is 2007-07-08.
Carl William Soderstrom's current location address is 4909 N Glen Park Place Rd, Peoria, Illinois. You can contact this provider via phone number 3096747546. The mailing address for Carl William Soderstrom is 4909 N Glen Park Place Rd, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Carl William Soderstrom |
|---|---|
| Address | 4909 N Glen Park Place Rd, Peoria, Illinois |
| Phone Number | 3096747546 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1053370759 |
|---|---|
| Provider Enumeration Date | 2006-03-21 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 4909 N Glen Park Place Rd |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616144676 |
| Phone Number | 3096747546 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dermatology |
|---|---|
| Taxonomy | 207N00000X |
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Definition: A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had |
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What is the unique identification code assigned to Carl William Soderstrom by the Centers for Medicare & Medicaid Services?
The Carl William Soderstrom has been issued the NPI (National Provider Identifier) 1053370759. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Carl William Soderstrom?
The Carl William Soderstrom is physically situated at 4909 N Glen Park Place Rd, in the city of Peoria, state of IL, with the postal code 616144676.
What is Carl William Soderstrom's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Carl William Soderstrom is Dermatology, and the taxonomy classification code that categorizes this area of expertise is 207N00000X.
When was the Carl William Soderstrom's 1053370759 issued?
The Carl William Soderstrom's 1053370759 was issued on 2006-03-21.
When was the information regarding Carl William Soderstrom most recently updated?
The details pertaining to the Carl William Soderstrom, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.
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