| Dr Gabriel Soudry, MD | |
|
9000 Franklin Square Dr, Baltimore, MD 21237-3901 | |
| (410) 935-6685 | |
| Not Available |
| Full Name | Dr Gabriel Soudry |
|---|---|
| Gender | Male |
| Speciality | Nuclear Medicine |
| Experience | 39 Years |
| Location | 9000 Franklin Square Dr, Baltimore, Maryland |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679681225 | NPI | - | NPPES |
| T3900001 | Other | DC | BLUE SHIELD |
| 60982201 | Other | MD | BLUE SHIELD |
| 364201100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | D45134 (Maryland) | Secondary |
| 207U00000X | Nuclear Medicine | D45134 (Maryland) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Medstar Franklin Square Medical Center | Baltimore, MD | Hospital |
| Medstar Harbor Hospital | Baltimore, MD | Hospital |
| Medstar Union Memorial Hospital | Baltimore, MD | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Medstar Medical Group Ii Llc | 0547413825 | 2998 |
| Advanced Radiology P A | 1254327950 | 144 |
| Medstar Medical Group Ii Llc | 0547413825 | 2998 |
| Entity Name | Advanced Radiology P A |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932167178 PECOS PAC ID: 1254327950 Enrollment ID: O20040420001334 |
| Entity Name | Medstar Medical Group Ii Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184046187 PECOS PAC ID: 0547413825 Enrollment ID: O20130117000347 |
| Entity Name | Medstar Medical Group Radiology, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326450156 PECOS PAC ID: 1557589157 Enrollment ID: O20140822001847 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Gabriel Soudry, MD 9000 Franklin Square Dr, Baltimore, MD 21237-3901 Ph: (410) 935-6685 | Dr Gabriel Soudry, MD 9000 Franklin Square Dr, Baltimore, MD 21237-3901 Ph: (410) 935-6685 |