Healthcare Provider Details

I. General information

NPI: 1922926682
Provider Name (Legal Business Name): SUMMER MARCHELLO LANIER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 TOWNE CENTER BLVD STE 701
POOLER GA
31322-4063
US

IV. Provider business mailing address

1139 LEXINGTON AVE STE A
SAVANNAH GA
31404-5502
US

V. Phone/Fax

Practice location:
  • Phone: 912-303-4200
  • Fax: 912-790-2701
Mailing address:
  • Phone: 912-547-4253
  • Fax: 912-790-2701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: