Provider Demographics
NPI:1831168574
Name:SODEN, CYLBURN EARL SR (MD)
Entity type:Individual
Prefix:MR
First Name:CYLBURN
Middle Name:EARL
Last Name:SODEN
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13920 BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5009
Mailing Address - Country:US
Mailing Address - Phone:301-776-0743
Mailing Address - Fax:301-776-0456
Practice Address - Street 1:13920 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5009
Practice Address - Country:US
Practice Address - Phone:301-776-0743
Practice Address - Fax:301-776-0456
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0024150207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD521382125OtherTAX ID
MD521382125OtherTAX ID
DC448002Medicare ID - Type UnspecifiedDC METRO AREA