Healthcare Provider Details

I. General information

NPI: 1427780691
Provider Name (Legal Business Name): SUMMER ELIZABETH FLEMING PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12925 HIGHWAY 601 STE 300
MIDLAND NC
28107
US

IV. Provider business mailing address

12925 HIGHWAY 601 STE 300
MIDLAND NC
28107-9536
US

V. Phone/Fax

Practice location:
  • Phone: 704-888-3702
  • Fax:
Mailing address:
  • Phone: 704-888-3702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number001012990
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: