Healthcare Provider Details

I. General information

NPI: 1275584591
Provider Name (Legal Business Name): ADAM N. SUMMERS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 JABEZ RUN
MILLERSVILLE MD
21108-2005
US

IV. Provider business mailing address

1520 JABEZ RUN
MILLERSVILLE MD
21108-2005
US

V. Phone/Fax

Practice location:
  • Phone: 410-553-9444
  • Fax:
Mailing address:
  • Phone: 410-553-9444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberD0055340
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: