MEDICARE: DR. DAVID IRA SOMMERS PH.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
1	103T00000X	Psychologist	1304	MD

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	:	1326036336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID IRA SOMMERS PH.D.

Provider Business Mailing Address
First Line	:	3750 UNIVERSITY BLVD W
Second Line	:	SUITE 304
City	:	KENSINGTON
State	:	MD
Zip	:	20895-2136
Country	:	US
Telephone Number	:	301-933-3018
Fax Number	:	301-933-6855

Provider Business Practice Location Address
First Line	:	3750 UNIVERSITY BLVD W
Second Line	:	SUITE 304
City	:	KENSINGTON
State	:	MD
Zip	:	20895-2136
Country	:	US
Telephone Number	:	301-933-3018
Fax Number	:	301-933-6855

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

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	11/20/2010

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