MEDICARE: MICHAEL GRANT SOMERMEYER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	26802	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	NP0202	OTHER	MN	AMERICA'S PPO
3	16596SO	OTHER	MN	BLUE CROSS BLUE SHIELD MN
4	7734	OTHER	MN	PREFERRED ONE
5	3127804	OTHER	MN	MEDICA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	100269C028	OTHER	MN	UCARE
8	HP14441	OTHER	MN	HEALTHPARTNERS

General Provider Information

NPI Number	:	1023038981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL GRANT SOMERMEYER M.D.

Provider Business Mailing Address
First Line	:	6200 SHINGLE CREEK PKWY
Second Line	:	SUITE 260
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55430-2128
Country	:	US
Telephone Number	:	763-561-5349
Fax Number	:

Provider Business Practice Location Address
First Line	:	6200 SHINGLE CREEK PKWY
Second Line	:	SUITE 250
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55430-2128
Country	:	US
Telephone Number	:	763-544-0696
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	11/09/2020

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