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General NPI Number Information
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NPI Number | 1992339493
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Entity Type | Organization
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Legal Business Name | SUMMIT MEDICAL CENTER
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Dates
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Enumeration Date | 02/24/2020
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 6350 E 2ND ST
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City | CASPER
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State | WY
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Zip | 82609-4264
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Country | US
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Telephone | 307-232-3235
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Fax | 307-215-0898
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Provider Business Mailing Address
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Address Line | 6350 E 2ND ST
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City | CASPER
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State | WY
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Zip | 82609-4264
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Country | US
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Telephone | 307-232-3235
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Fax | 307-215-0898
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Authorized Official
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Title or Position | CEO
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Name | RAYMOND VUCETIC
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Credential |
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Telephone | 307-232-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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