Healthcare Provider Details

I. General information

NPI: 1417914581
Provider Name (Legal Business Name): LEIGH RINGER SUMMER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 08/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6614 SHALLOWFORD RD
LEWISVILLE NC
27023-9504
US

IV. Provider business mailing address

6580 SHALLOWFORD RD STE 130
LEWISVILLE NC
27023-8730
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-2255
  • Fax: 336-945-2039
Mailing address:
  • Phone: 336-716-2255
  • Fax: 336-945-2039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2003-01417
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: