Provider Demographics
NPI:1740248210
Name:SORENSON, DAVID E (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:SORENSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3 P STREET
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950
Mailing Address - Country:US
Mailing Address - Phone:978-388-5700
Mailing Address - Fax:978-388-4052
Practice Address - Street 1:24 MORRILL PLACE
Practice Address - Street 2:AMESBURY PSYCHOLOGICAL CENTER INC
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-3530
Practice Address - Country:US
Practice Address - Phone:978-358-5700
Practice Address - Fax:978-388-4052
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA569602084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9765352Medicaid
MAJ06781Medicare PIN
A59194Medicare UPIN