Provider Demographics
NPI:1861484784
Name:SOMMER, RAND W (MD)
Entity Type:Individual
Prefix:DR
First Name:RAND
Middle Name:W
Last Name:SOMMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:506 ST LUKES CENTER DR
Mailing Address - Street 2:SUITE 506
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3509
Mailing Address - Country:US
Mailing Address - Phone:314-576-8102
Mailing Address - Fax:314-576-8122
Practice Address - Street 1:121 SAINT LUKES CENTER DR STE 506
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3519
Practice Address - Country:US
Practice Address - Phone:314-576-8102
Practice Address - Fax:314-590-5930
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMDR3D27207RR0500X
MOR3D27207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP00317321OtherRAILROAD MEDICARE
MO002013444Medicare PIN
MOA12319Medicare UPIN