Provider Demographics
NPI:1952387128
Name:SOMERS, HERBERT (MD)
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:
Last Name:SOMERS
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:PO BOX 820933
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0933
Mailing Address - Country:US
Mailing Address - Phone:215-926-9010
Mailing Address - Fax:215-226-8285
Practice Address - Street 1:9331 OLD BUSTLETON AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19115-4634
Practice Address - Country:US
Practice Address - Phone:215-602-8900
Practice Address - Fax:215-602-8904
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD027457L207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000754289Medicaid
PA5906OtherBRAVO HEALTH
PA0183363OtherHIGHMARK BLUE SHIELD
PA30038138OtherKEYSTONE MERCY HEALTH
PA160038634OtherRAILROAD MEDICARE
PA3Y4126OtherHEALTH NET
PA0052728000OtherINDEPENDENCE BLUE CROSS
PA30008921OtherKEYSTONE MERCY HEALTH
PA4482994OtherAETNA PPO
PAP938413OtherOXFORD
PA454512OtherCOVENTRY HEALTH AMERICA
PA4482994OtherAETNA PPO
PA0052728000OtherINDEPENDENCE BLUE CROSS