Mr Clifford C Souder, PHYSICIAN ASSISTANT in Leesburg, VA

Mr Clifford C Souder, PHYSICIAN ASSISTANT is a medicare enrolled "Physician Assistant" in Leesburg, Virginia. His current practice location is 601 Potomac Station Dr Ne, Leesburg, Virginia. You can reach out to his office (for appointments etc.) via phone at (703) 840-1396.

Mr Clifford C Souder is licensed to practice in Virginia (license number 0110003746) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1679751200.

Contact Information

	Mr Clifford C Souder, PHYSICIAN ASSISTANT
	601 Potomac Station Dr Ne, Leesburg, VA 20176-1816
	(703) 840-1396
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Clifford C Souder
Gender	Male
Speciality	Physician Assistant
Location	601 Potomac Station Dr Ne, Leesburg, Virginia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1679751200
Provider Enumeration Date: 02/06/2008
Last Update Date: 01/29/2025

Medicare PECOS Information:

PECOS PAC ID: 8325275670
Enrollment ID: I20131212001555

Medical Identifiers

Medical identifiers for Mr Clifford C Souder such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1679751200	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	0110003746 (Virginia)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Clifford C Souder is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Clifford C Souder, PHYSICIAN ASSISTANT 238 Brookley Ave Sw, Bolling Afb, DC 20032-7704 Ph: (202) 404-6491	Mr Clifford C Souder, PHYSICIAN ASSISTANT 601 Potomac Station Dr Ne, Leesburg, VA 20176-1816 Ph: (703) 840-1396

Reviews and Comments

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Mr Clifford C Souder, PHYSICIAN ASSISTANT - Medicare Physician Assistant in Leesburg, VA