Healthcare Provider Details

I. General information

NPI: 1730138546
Provider Name (Legal Business Name): SUMMIT MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 09/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 PEACHTREE ST NE NORTH TOWER, SUITE 2100
ATLANTA GA
30303-1401
US

IV. Provider business mailing address

235 PEACHTREE ST NE NORTH TOWER, SUITE 2100
ATLANTA GA
30303-1401
US

V. Phone/Fax

Practice location:
  • Phone: 770-994-9326
  • Fax: 770-994-9326
Mailing address:
  • Phone: 770-994-9326
  • Fax: 770-994-9326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL DOW BOURLAND
Title or Position: PRESIDENT & CEO
Credential: MD
Phone: 770-994-9326