Doctor Name: | IAN DOUGLAS SOMERVILLE |
NPI Number: | 1679566186 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | D14544 |
Business Practice Address: | 400 Lewis St Havre De Grace, MD - 210783405 |
Business Phone Number: | 4109395300 |
Business Fax Number: | 4109396485 |
Mailing Address: | 400 Lewis St, HAVRE DE GRACE |
State: | MD |
Postal Code: | 210783405 |
Phone Number: | 4109395300 |
Fax Number: | 4109396485 |
NPI Enumeration Date: | 08/30/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | D14544 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |