Provider Demographics
NPI:1386742880
Name:SOMERS, MICHAEL E (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
Last Name:SOMERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2790 CLAY EDWARDS DR
Mailing Address - Street 2:SUITE 1240
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3276
Mailing Address - Country:US
Mailing Address - Phone:816-842-2015
Mailing Address - Fax:816-221-3713
Practice Address - Street 1:2790 CLAY EDWARDS DR
Practice Address - Street 2:SUITE 1240
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3276
Practice Address - Country:US
Practice Address - Phone:816-842-2015
Practice Address - Fax:816-221-3713
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2020-06-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR2P72207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOB65515Medicare UPIN
MO0002734Medicare ID - Type Unspecified