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General NPI Number Information
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NPI Number | 1376578997
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Entity Type | Individual
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Provider Name | MICHELE SUMMERS COLON D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 180 OLD LOUDON RD
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City | LATHAM
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State | NY
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Zip | 12110-3905
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Country | US
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Telephone | 518-608-4587
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Fax | 518-608-4768
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Provider Business Mailing Address
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Address Line | 33 CORNELL AVE
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City | RED HOOK
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State | NY
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Zip | 12571-1000
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Country | US
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Telephone | 626-315-5434
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E4053
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | N007219
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License Number State | NY
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