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General NPI Number Information
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NPI Number | 1295865954
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Entity Type | Organization
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Legal Business Name | ROSS SUMMERS MD PLLC
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 01/11/2011
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Provider Practice Location Address
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Address Line | 308 S MAIN ST
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City | NORTHVILLE
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State | MI
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Zip | 48167-1646
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Country | US
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Telephone | 248-349-0627
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Fax | 248-380-9365
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Provider Business Mailing Address
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Address Line | 308 S MAIN ST
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City | NORTHVILLE
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State | MI
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Zip | 48167-1646
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Country | US
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Telephone | 248-349-0627
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Fax | 248-380-9365
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. ROSS A SUMMERS
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Credential | M.D.
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Telephone | 248-349-0627
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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 | 4301057732
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301071154
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301068380
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 4301058039
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 4301046792
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301082667
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License Number State | MI
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Taxonomy #7
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301074604
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License Number State | MI
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