Provider Demographics
NPI:1992715957
Name:SOMMERS, LINDA MAUREEN (FACS)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:MAUREEN
Last Name:SOMMERS
Suffix:
Gender:F
Credentials:FACS
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Other - First Name:
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Mailing Address - Street 1:595 MARTHA JEFFERSON DR
Mailing Address - Street 2:SUITE 320
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-4669
Mailing Address - Country:US
Mailing Address - Phone:434-984-2909
Mailing Address - Fax:434-984-3011
Practice Address - Street 1:595 MARTHA JEFFERSON DR
Practice Address - Street 2:SUITE 320
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-4669
Practice Address - Country:US
Practice Address - Phone:434-984-2909
Practice Address - Fax:434-984-3011
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101053335208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007306504Medicaid
VA007306504Medicaid
VA00W598V43Medicare PIN