Provider Demographics
NPI:1699833905
Name:SOMMER, ANTHONY G (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:G
Last Name:SOMMER
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 1:9010 W CHEYENNE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-8932
Mailing Address - Country:US
Mailing Address - Phone:702-240-8646
Mailing Address - Fax:702-240-0206
Practice Address - Street 1:9010 W CHEYENNE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-8932
Practice Address - Country:US
Practice Address - Phone:702-240-8646
Practice Address - Fax:702-240-0206
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV7458207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F98187Medicare UPIN