Healthcare Provider Details

I. General information

NPI: 1396004719
Provider Name (Legal Business Name): MEREDITH ELAINE SOMMERVILLE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEREDITH ELAINE KENNEDY MD

II. Dates (important events)

Enumeration Date: 05/04/2012
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 WOODLAND ST
HARTFORD CT
06105-1208
US

IV. Provider business mailing address

114 WOODLAND ST
HARTFORD CT
06105-1208
US

V. Phone/Fax

Practice location:
  • Phone: 860-714-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberD0087513
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number1.08147
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number01073628A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: