Healthcare Provider Details

I. General information

NPI: 1922043702
Provider Name (Legal Business Name): SUMMIT MEDICAL DIAGNOSTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 07/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11842 ROCK LANDING DR SUITE 110
NEWPORT NEWS VA
23606-4437
US

IV. Provider business mailing address

PO BOX 1247
CHESAPEAKE VA
23327-1247
US

V. Phone/Fax

Practice location:
  • Phone: 757-873-9580
  • Fax: 757-873-9050
Mailing address:
  • Phone: 757-410-8954
  • Fax: 757-410-8963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KIM S CHARNEY
Title or Position: SOLE PROPRIETOR
Credential: D.C.
Phone: 757-873-9580