Basic Information
| Provider Information | |||||||||
| NPI: | 1659332245 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOYKE | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 CROMWELL BRIDGE RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | TOWSON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212863300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108217775 | ||||||||
| FaxNumber: | 4108211320 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 CROMWELL BRIDGE RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | TOWSON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212863300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108217775 | ||||||||
| FaxNumber: | 4108211320 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2006 | ||||||||
| LastUpdateDate: | 11/28/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | C00315 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
ID Information
| ID | Type | State | Issuer | Description | CN6601 | 01 | MD | R/R MEDICARE GROUP # | OTHER | 970005966 | 01 | MD | R/R MEDICARE PROVIDER # | OTHER |