Provider Demographics
NPI:1174594246
Name:SOMERS, KARA E (MD)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:E
Last Name:SOMERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 91734
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23291-1734
Mailing Address - Country:US
Mailing Address - Phone:804-358-6100
Mailing Address - Fax:804-342-7619
Practice Address - Street 1:1000 E BROAD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219
Practice Address - Country:US
Practice Address - Phone:804-828-2647
Practice Address - Fax:804-827-4180
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101046484208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1030308OtherUNITED HEALTHCARE
VA9749OtherSOUTHERN HEALTH
VA006712495Medicaid
VA52776OtherOPTIMA HEALTHCARE
VAC09633OtherGROUP PTAN
VA231006OtherANTHEM
VA101137OtherCIGNA
VA541817338OtherFEDERAL TAX ID
VA5821677OtherAETNA