Soderdahl, Douglas Wayne

Soderdahl, Douglas Wayne is an individual health care provider with primary practice located at 3851 Roger Brooke Drive Mche-Qd, Fort Sam Houston TX 78234-6200. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Military Health Care Provider, Allopathic & Osteopathic Physicians / Urology. Allopathic & Osteopathic Physicians / Urology is his primary health care specialty. Soderdahl, Douglas Wayne can be contacted via phone (210) 916-2460.

Contact Information

Primary practice address
3851 Roger Brooke Drive Mche-Qd Fort Sam Houston TX 78234-6200
Phone: (210) 916-2460
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Military Health Care Provider 171000000X 0101233888 Virginia
Allopathic & Osteopathic Physicians / Urology 208800000X 34673-20 Wisconsin

Profile Details

NPI number 1245217769
LBN Legal business name Soderdahl, Douglas Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2005
Last updated May 13th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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