DR. VICTOR STEPHEN SODERSTROM DPM NPI 1508810110

NPI Information

  • NPI: 1508810110
  • Provider Name: DR. VICTOR STEPHEN SODERSTROM, DPM
  • Classification: Podiatrist - 213E00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 101 OAKRIDGE CT
    STE A
    WATERTOWN, WI
    ZIP 53094
  • Phone: (920) 261-9610

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NPI Details

DR. Victor Stephen Soderstrom, DPM is a podiatrist in Watertown, WI. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. DR. Victor Stephen Soderstrom, DPM NPI is 1508810110. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

101 OAKRIDGE CT
STE A
WATERTOWN, WI
ZIP 53094-150
Phone: (920) 261-9610
Fax: (920) 261-9671

The NPI 1508810110 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 5/19/2006 and was last updated on 11/12/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatrist444025WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
143200300MEDICAIDWISCONSIN
2864350002MEDICARE ID-TYPE UNSPECIFIEDWISCONSIN
3T63373MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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