MEDICARE: DR. DAVID E SORENSON MD

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	2084P0804X	Child & Adolescent Psychiatry Physician	56960	MA

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

General Provider Information

NPI Number	:	1740248210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID E SORENSON MD

Provider Business Mailing Address
First Line	:	3 P STREET
Second Line	:
City	:	NEWBURYPORT
State	:	MA
Zip	:	01950
Country	:	US
Telephone Number	:	978-388-5700
Fax Number	:	978-388-4052

Provider Business Practice Location Address
First Line	:	24 MORRILL PLACE
Second Line	:	AMESBURY PSYCHOLOGICAL CENTER INC
City	:	AMESBURY
State	:	MA
Zip	:	01913-3530
Country	:	US
Telephone Number	:	978-358-5700
Fax Number	:	978-388-4052

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

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	03/04/2015

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