Individual
MATTHEW THOMAS SOMERVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2694
Mailing address
1070 MAPLETON AVE, SUFFIELD, CT 06078-1380
(860) 930-4249
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/22/2021
Last updated
03/22/2021
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