Provider Demographics
NPI:1568579407
Name:SOMMERVILLE, DREW NELSON (MD)
Entity Type:Individual
Prefix:DR
First Name:DREW
Middle Name:NELSON
Last Name:SOMMERVILLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6149 E COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-9134
Mailing Address - Country:US
Mailing Address - Phone:812-424-2020
Mailing Address - Fax:812-424-3000
Practice Address - Street 1:6149 E COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715
Practice Address - Country:US
Practice Address - Phone:812-424-2020
Practice Address - Fax:812-424-3000
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036124386207W00000X
KY41117207W00000X
IN01066351A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200941720Medicaid
KY7100011560Medicaid
IN200941720Medicaid
IN200941720Medicaid