Provider Demographics
NPI:1740210830
Name:SOMMERS, WILLIAM (DO)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:SOMMERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CHAVILLE WAY
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19807-1422
Mailing Address - Country:US
Mailing Address - Phone:302-428-0585
Mailing Address - Fax:
Practice Address - Street 1:620 STANTON CHRISTIANA RD
Practice Address - Street 2:STE.302
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2133
Practice Address - Country:US
Practice Address - Phone:302-892-9400
Practice Address - Fax:302-892-9407
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC20002717174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE023203Medicaid
29893OtherBOARD CERT-NEUROLOGY
DE023203Medicaid
DE166835W34Medicare ID - Type Unspecified