Provider Demographics
NPI:1558362251
Name:SOMERSET, ELIZABETH D (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:D
Last Name:SOMERSET
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:29751 LITTLE MACK AVE
Mailing Address - Street 2:STE B
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-6503
Mailing Address - Country:US
Mailing Address - Phone:586-415-6200
Mailing Address - Fax:586-415-6217
Practice Address - Street 1:29751 LITTLE MACK AVE
Practice Address - Street 2:STE B
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-6503
Practice Address - Country:US
Practice Address - Phone:586-415-6200
Practice Address - Fax:586-415-6217
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301068602207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E061676161OtherMEDICARE PROVIDER
MI3285058Medicaid
MI3285058Medicaid
MI0E061676161OtherMEDICARE PROVIDER