Provider Demographics
NPI:1043629462
Name:SOMERS, SEAN M (PHARMD/RPH)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:M
Last Name:SOMERS
Suffix:
Gender:M
Credentials:PHARMD/RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10687 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:PLAINWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49080-9630
Mailing Address - Country:US
Mailing Address - Phone:269-217-4423
Mailing Address - Fax:
Practice Address - Street 1:10687 N 10TH ST
Practice Address - Street 2:
Practice Address - City:PLAINWELL
Practice Address - State:MI
Practice Address - Zip Code:49080-9630
Practice Address - Country:US
Practice Address - Phone:269-217-4423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302040126183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist