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NPI Code Detail

MEDICARE: MEGAN OLIVER SUMNER PA

MEDICARE: MEGAN OLIVER SUMNER PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant1964SC
2363A00000XPhysician Assistant1964SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720414733
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN OLIVER SUMNER PA
Provider Business Mailing Address
First Line : PO BOX 749306
Second Line :
City : ATLANTA
State : GA
Zip : 30374-9306
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 743 FOLLY RD
Second Line :
City : CHARLESTON
State : SC
Zip : 29412-3432
Country : US
Telephone Number : 843-762-2360
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2013
Last Update Date : 11/15/2024

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