Provider Demographics
NPI:1669262754
Name:SOMERSET PRIMARY CARE LLC
Entity type:Organization
Organization Name:SOMERSET PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HAFT
Authorized Official - Suffix:
Authorized Official - Credentials:MF
Authorized Official - Phone:301-751-9330
Mailing Address - Street 1:382 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CRISFIELD
Mailing Address - State:MD
Mailing Address - Zip Code:21817-1329
Mailing Address - Country:US
Mailing Address - Phone:667-868-4027
Mailing Address - Fax:667-868-4044
Practice Address - Street 1:382 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CRISFIELD
Practice Address - State:MD
Practice Address - Zip Code:21817-1329
Practice Address - Country:US
Practice Address - Phone:667-868-4027
Practice Address - Fax:667-868-4044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center