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General NPI Number Information
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NPI Number | 1275733818
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Entity Type | Individual
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Provider Name | BENJAMIN D SOMMERS M.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 02/25/2013
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Provider Practice Location Address
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Address Line | 3297 WASHINGTON ST
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City | JAMAICA PLAIN
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State | MA
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Zip | 02130-2655
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Country | US
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Telephone | 617-522-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 75 FRANCIS ST
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City | BOSTON
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State | MA
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Zip | 02115-6110
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Country | US
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Telephone | 857-307-0896
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 232398
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD039914
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License Number State | DC
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