Individual
EDMUNDO A SOMOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11600 STATE ROUTE 424, NAPOLEON, OH 43545-9719
(419) 592-4015
Mailing address
PO BOX 1046, LIMA, OH 45802-1046
(419) 224-5707
(419) 229-0040
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35.049675
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000391229
ANTHEM BLUE CROSS BLUE SH
OH
05
—
0522581
—
OH
Enumeration date
05/11/2006
Last updated
07/08/2011
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