Provider Demographics
NPI:1972036325
Name:SOMASHEKAR, ANUPAM
Entity Type:Individual
Prefix:
First Name:ANUPAM
Middle Name:
Last Name:SOMASHEKAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 N YORK DR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-3165
Mailing Address - Country:US
Mailing Address - Phone:484-478-4937
Mailing Address - Fax:
Practice Address - Street 1:798 HAUSMAN RD FL 1
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9108
Practice Address - Country:US
Practice Address - Phone:610-776-5038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA29991164390200000X
PAMD478201207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program