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NPI Code Detail

MEDICARE: MICHAEL J SOMERS M.D.

MEDICARE: MICHAEL J SOMERS 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
1208000000XPediatrics Physician72816MA
22080P0210XPediatric Nephrology Physician72816MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1B501026OTHERMACIGNA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
30003884OTHERMANEIGHBORHOOD HEALTH
4J13559OTHERMABLUE CROSS
5072816OTHERMATUFTS
6PP491OTHERMAHARVARD PILGRIM

General Provider Information

NPI Number : 1649240425
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL J SOMERS M.D.
Provider Business Mailing Address
First Line : 300 LONGWOOD AVE
Second Line :
City : BOSTON
State : MA
Zip : 02115-5724
Country : US
Telephone Number : 617-355-6129
Fax Number : 617-730-0569
Provider Business Practice Location Address
First Line : 300 LONGWOOD AVE
Second Line :
City : BOSTON
State : MA
Zip : 02115-5724
Country : US
Telephone Number : 617-355-6129
Fax Number : 617-730-0569
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 02/11/2014

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