Healthcare Provider Details

I. General information

NPI: 1669262754
Provider Name (Legal Business Name): SOMERSET PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

382 W MAIN ST
CRISFIELD MD
21817-1329
US

IV. Provider business mailing address

382 W MAIN ST
CRISFIELD MD
21817-1329
US

V. Phone/Fax

Practice location:
  • Phone: 667-868-4027
  • Fax: 667-868-4044
Mailing address:
  • Phone: 667-868-4027
  • Fax: 667-868-4044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HOWARD HAFT
Title or Position: PRESIDENT
Credential: MF
Phone: 301-751-9330