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General NPI Number Information
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NPI Number | 1295818441
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Entity Type | Organization
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Legal Business Name | CAROLINA PREMIER HEALTH CARE PA
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 630 S BENNETT STREET
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City | SOUTHERN PINES
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State | NC
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Zip | 28384
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Country | US
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Telephone | 910-693-1678
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Fax | 910-693-1612
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Provider Business Mailing Address
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Address Line | 630 S BENNETT STREET
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City | SOUTHERN PINES
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State | NC
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Zip | 28384
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Country | US
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Telephone | 910-693-1678
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Fax | 910-693-1612
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDREW SUMMERS
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Credential | MD
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Telephone | 910-693-1698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 38219
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License Number State | NC
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