Provider Demographics
NPI:1861759227
Name:SOMMER, JESSICA LAUREN (DO)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LAUREN
Last Name:SOMMER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4550 STRUTFIELD LN APT 2414
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-4977
Mailing Address - Country:US
Mailing Address - Phone:518-528-4937
Mailing Address - Fax:
Practice Address - Street 1:1625 N GEORGE MASON DR STE 325
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3690
Practice Address - Country:US
Practice Address - Phone:703-717-4600
Practice Address - Fax:703-717-4601
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0102204588207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty