SUMMIT MEDICAL GROUP LLC NPI 1952970816

NPI Information

NPI: 1952970816
Provider Name: SUMMIT MEDICAL GROUP LLC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 21D1021899

Address:
6310 STEVENS FOREST RD STE 200
COLUMBIA, MD
ZIP 21046
Phone: (410) 740-9001
Get Directions

SUMMIT MEDICAL GROUP LLC is a multi-specialty clinic center in Columbia, MD. SUMMIT MEDICAL GROUP LLC NPI is 1952970816. The provider is registered as an organization entity type.

The provider's business location address is:

6310 STEVENS FOREST RD STE 200
COLUMBIA, MD
ZIP 21046-068
Phone: (410) 740-9001
Fax: (410) 740-9005

The provider's authorized official is Njideka Udochi .
The authorized official title is Owner and has the following contact phone number (410) 245-2414.

The CLIA number assigned to this NPI record is 21D1021899 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/23/2021 and was last updated on 12/13/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	D00051897	OTHER	MARYLAND	MD LICENSE
2	685900301	MEDICAID	MARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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