Provider Demographics
NPI:1871554220
Name:SOOBERT, KARIN L (MD)
Entity type:Individual
Prefix:DR
First Name:KARIN
Middle Name:L
Last Name:SOOBERT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:100 EMANCIPATION DR
Mailing Address - Street 2:VETERANS AFFAIRS MEDICAL CENTER (590/170)
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23667-0001
Mailing Address - Country:US
Mailing Address - Phone:757-722-9961
Mailing Address - Fax:757-728-3465
Practice Address - Street 1:100 EMANCIPATION DR
Practice Address - Street 2:VETERANS AFFAIRS MEDICAL CENTER (590/170)
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23667-0001
Practice Address - Country:US
Practice Address - Phone:757-722-9961
Practice Address - Fax:757-728-3465
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101-038407207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006594Medicare UPIN