Healthcare Provider Details

I. General information

NPI: 1992339493
Provider Name (Legal Business Name): SUMMIT MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2020
Last Update Date: 08/05/2020
Certification Date: 08/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6350 E 2ND ST
CASPER WY
82609-4264
US

IV. Provider business mailing address

6350 E 2ND ST
CASPER WY
82609-4264
US

V. Phone/Fax

Practice location:
  • Phone: 307-232-3235
  • Fax: 307-215-0898
Mailing address:
  • Phone: 307-232-3235
  • Fax: 307-215-0898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: RAYMOND VUCETIC
Title or Position: CEO
Credential:
Phone: 307-232-6600