Healthcare Provider Details
I. General information
NPI: 1225041213
Provider Name (Legal Business Name): SUMMIT HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2006
Last Update Date: 03/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27175 HAGGERTY RD
NOVI MI
48377-3626
US
IV. Provider business mailing address
27175 HAGGERTY RD
NOVI MI
48377-3626
US
V. Phone/Fax
- Phone: 248-799-8303
- Fax: 248-799-8927
- Phone: 248-799-8303
- Fax: 248-799-8927
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171W00000X |
| Taxonomy | Contractor |
| License Number | NONE |
| License Number State | MI |
VIII. Authorized Official
Name: MR.
RICHARD
ALDEN
PENINGTON
Title or Position: PRESIDENT
Credential:
Phone: 248-799-8303