=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922585736
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SUMMIT CONSULTING FOR POST ACUTE CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/24/2018
-----------------------------------------------------
Last Update Date | 07/24/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1170 ALKI AVE SW APT 301
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98116-4828
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-595-3383
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1170 ALKI AVE SW APT 301
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98116-4828
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-595-3383
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MOHAMMED M MURAYWID
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 206-595-3383
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | MD00045913
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------