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NPI Code Detail

MEDICARE: MICHAEL SUMMERS

MEDICARE: MICHAEL SUMMERS
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
1207K00000XAllergy & Immunology Physician0101273522VA
2207Q00000XFamily Medicine Physician01034573AIN
3207Q00000XFamily Medicine Physician0101273522VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000599162OTHERANTHEM PIN#
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3P00696807OTHERRR MCR#

General Provider Information

NPI Number : 1891719324
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL SUMMERS
Provider Business Mailing Address
First Line : 250 N SHADELAND AVE
Second Line : STE 130
City : INDIANAPOLIS
State : IN
Zip : 46219-4959
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12101 CAROL LN STE 101
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22407-6104
Country : US
Telephone Number : 540-741-9300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 07/14/2025

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Directions to “ MICHAEL SUMMERS ” Practice Location

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