Provider Demographics
NPI:1407843246
Name:SOMMERKAMP, T GREG (MD)
Entity Type:Individual
Prefix:DR
First Name:T
Middle Name:GREG
Last Name:SOMMERKAMP
Suffix:
Gender:M
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 637783
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-7783
Mailing Address - Country:US
Mailing Address - Phone:513-853-4731
Mailing Address - Fax:513-569-5199
Practice Address - Street 1:545 CENTRE VIEW BLVD
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3444
Practice Address - Country:US
Practice Address - Phone:859-344-1150
Practice Address - Fax:859-344-1711
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY27995174400000X
KYKY027995207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64279953Medicaid
OHH214760Medicare PIN
KYE04447Medicare UPIN
KY3290Medicare PIN
KYDD3051Medicare PIN