Basic Information
| Provider Information | |||||||||
| NPI: | 1346293099 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KNITTIG | ||||||||
| FirstName: | SOMMER | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 11314 | ||||||||
| Address2: | |||||||||
| City: | BELFAST | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049154004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7578424481 | ||||||||
| FaxNumber: | 7573123135 | ||||||||
| Practice Location | |||||||||
| Address1: | 908 EDEN WAY N STE 101 | ||||||||
| Address2: | |||||||||
| City: | CHESAPEAKE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 233203336 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7573126267 | ||||||||
| FaxNumber: | 7578197185 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2006 | ||||||||
| LastUpdateDate: | 11/24/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME0091963 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 272843500 | 05 | FL | MEDICAID |