Healthcare Provider Details

I. General information

NPI: 1508975848
Provider Name (Legal Business Name): TIMUR SUMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

G3285 BEECHER RD
FLINT MI
48532-3615
US

IV. Provider business mailing address

G3285 BEECHER RD
FLINT MI
48532-3615
US

V. Phone/Fax

Practice location:
  • Phone: 810-235-6685
  • Fax: 810-720-8293
Mailing address:
  • Phone: 810-235-6685
  • Fax: 810-720-8293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberTS059016
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: