Provider Demographics
NPI:1346293099
Name:KNITTIG, SOMMER (MD)
Entity Type:Individual
Prefix:DR
First Name:SOMMER
Middle Name:
Last Name:KNITTIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11314
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4004
Mailing Address - Country:US
Mailing Address - Phone:757-842-4481
Mailing Address - Fax:757-312-3135
Practice Address - Street 1:908 EDEN WAY N STE 101
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3336
Practice Address - Country:US
Practice Address - Phone:757-312-6267
Practice Address - Fax:757-819-7185
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0091963207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272843500Medicaid
71524Medicare UPIN
16101ZMedicare ID - Type Unspecified