Provider Demographics
NPI:1770521676
Name:SOMIAH, SACHDEV (MD)
Entity type:Individual
Prefix:DR
First Name:SACHDEV
Middle Name:
Last Name:SOMIAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1536 BRIDGEWATER LN STE 103
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-4103
Mailing Address - Country:US
Mailing Address - Phone:423-245-2406
Mailing Address - Fax:423-245-2404
Practice Address - Street 1:1536 BRIDGEWATER LN STE 103
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-4103
Practice Address - Country:US
Practice Address - Phone:423-245-2406
Practice Address - Fax:423-245-2404
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD394102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4106560OtherBCBS OF TN
TN3329856Medicaid
H14728Medicare UPIN
TN3329856Medicare ID - Type Unspecified