Provider Demographics
NPI:1063406395
Name:DR JULIAN N SOBER PA
Entity type:Organization
Organization Name:DR JULIAN N SOBER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:SOBER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:410-768-4300
Mailing Address - Street 1:420 CRAIN HWY S
Mailing Address - Street 2:SUITE #2
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-3657
Mailing Address - Country:US
Mailing Address - Phone:410-768-4300
Mailing Address - Fax:410-768-4301
Practice Address - Street 1:420 CRAIN HWY S
Practice Address - Street 2:SUITE #2
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3657
Practice Address - Country:US
Practice Address - Phone:410-768-4300
Practice Address - Fax:410-768-4301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-01
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty