Provider Demographics
NPI:1437137841
Name:SOMMER, MATTHEW DAVID (CRNP)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:DAVID
Last Name:SOMMER
Suffix:
Gender:M
Credentials:CRNP
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Mailing Address - Street 1:4448 PROSPECT RD
Mailing Address - Street 2:
Mailing Address - City:WHITEFORD
Mailing Address - State:MD
Mailing Address - Zip Code:21160-1304
Mailing Address - Country:US
Mailing Address - Phone:410-399-0384
Mailing Address - Fax:410-783-0569
Practice Address - Street 1:KIRK US ARMY HEALTH CLINIC
Practice Address - Street 2:6455 MACHINE STREET
Practice Address - City:ABERDEEN PROVING GROUND
Practice Address - State:MD
Practice Address - Zip Code:21005-5131
Practice Address - Country:US
Practice Address - Phone:410-436-3001
Practice Address - Fax:410-436-8409
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2023-08-29
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Provider Licenses
StateLicense IDTaxonomies
MDR137599363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD699304400Medicaid