Provider Demographics
NPI:1528164225
Name:SOMMER, GREGORY S (BS, DC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:S
Last Name:SOMMER
Suffix:
Gender:M
Credentials:BS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 W 11TH AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-2007
Mailing Address - Country:US
Mailing Address - Phone:717-430-6028
Mailing Address - Fax:717-430-6028
Practice Address - Street 1:30 W 11TH AVE
Practice Address - Street 2:SUITE B
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-2007
Practice Address - Country:US
Practice Address - Phone:717-430-6028
Practice Address - Fax:717-430-6029
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006634L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2718158OtherAETNA
PA5978317-001OtherCIGNA
PA03081100OtherCAPITOL BLUE CROSS
PW3000187OtherKEYSTONE
PA1639343Medicaid
PA1521299Medicaid
PA898944OtherHIGHMARK BLUE SHIELD
PA92220Medicaid
PW3000187OtherKEYSTONE
PA1521299Medicaid