Provider Demographics
NPI:1336107150
Name:SOMERTO, ANNA I (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:I
Last Name:SOMERTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:200 MILL RD
Mailing Address - Street 2:STE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:480 HAWTHORN ST
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-3713
Practice Address - Country:US
Practice Address - Phone:508-973-9180
Practice Address - Fax:508-973-9185
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2265742084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110075412AMedicaid
MA110075412AMedicaid
MA5632585OtherFIRST HEALTH
MAJ40617OtherBCBS
MA2131226Medicaid
MA9534258OtherCIGNA
MAA40709Medicare PIN