Provider Demographics
NPI:1528457579
Name:SOMMER, KARL WILLIAM (RPH)
Entity type:Individual
Prefix:MR
First Name:KARL
Middle Name:WILLIAM
Last Name:SOMMER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:461 CALLEN AVE
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-6472
Mailing Address - Country:US
Mailing Address - Phone:304-685-4311
Mailing Address - Fax:
Practice Address - Street 1:215 DON KNOTTS BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501-6734
Practice Address - Country:US
Practice Address - Phone:304-225-7979
Practice Address - Fax:304-225-3784
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-14
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV3925183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist