Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dylan Boyd Soderstrum, MD

Individual provider Emergency Medicine Physician · NPI 1720664188

Dylan Boyd Soderstrum, MD is an Emergency Medicine in Charlottesville, Virginia. Qualified in 2021, 5 years ago. Practices with St Tammany Emergency Physicians Group LLC, a 42-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
5
Licensed in
LA
In the registry since
2021
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1215 Lee St
Charlottesville, VA 22908-0816
Phone: (434) 924-8485
Fax: (434) 982-4118
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 341002 (LA)

Record details

NPI number1720664188
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 24, 2021
Last updated in NPPESAugust 7, 2024
Certification dateAugust 7, 2024
Mailing address1215 Lee St, Charlottesville, VA 22908-0816

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice St Tammany Emergency Physicians Group Llc — 42 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Charlottesville