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General NPI Number Information
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NPI Number | 1366753048
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Entity Type | Individual
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Provider Name | MICHAEL JAMES SUMNERS D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2010
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Last Update Date | 06/28/2010
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Provider Practice Location Address
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Address Line | 5900 BYRON CENTER AVE SW
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City | WYOMING
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State | MI
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Zip | 49519-9606
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Country | US
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Telephone | 517-862-9315
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Fax |
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Provider Business Mailing Address
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Address Line | 4325 TIMBER RIDGE TRL SW APT 6
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City | WYOMING
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State | MI
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Zip | 49519-4268
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Country | US
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Telephone | 517-862-9315
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 5101018712
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License Number State | MI
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