NPI 1295485571 · live from the CMS NPI Registry
Sommer Beane
Physician Assistant, Medical in Charleston, WV. National Provider Identifier 1295485571, active.
NPI record
| NPI | 1295485571 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Medical 363AM0700X |
| Practice location | 600 Tracy Way Ste 2, Charleston, WV 25311 |
| Practice phone | 304-346-8877 |
| Mailing address | 501 Morris St, Charleston, WV 25301 |
| Enumerated | March 28, 2022 |
| Last updated | August 30, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | — |
| Physician Assistant, Medical primary | 363AM0700X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.