MEDICARE: MR. CHRISTOPHER JAMES SOMMERS B.A.

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1760632798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTOPHER JAMES SOMMERS B.A.

Provider Business Mailing Address
First Line	:	1512 MERIDIAN ST
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201-5345
Country	:	US
Telephone Number	:	812-343-6357
Fax Number	:

Provider Business Practice Location Address
First Line	:	1512 MERIDIAN ST
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201-5345
Country	:	US
Telephone Number	:	812-343-6357
Fax Number	:

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

Provider Enumeration Date	:	09/26/2008
Last Update Date	:	09/26/2008

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Directions to “ MR. CHRISTOPHER JAMES SOMMERS B.A.” Practice Location

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