SUMMIT MEDICAL GROUP NPI 1235275207

NPI Information

NPI: 1235275207
Provider Name: SUMMIT MEDICAL GROUP
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
100 HIGHLAND AVE STE 307
PROVIDENCE, RI
ZIP 02906
Phone: (401) 331-5320
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SUMMIT MEDICAL GROUP is a primary care clinic center in Providence, RI. SUMMIT MEDICAL GROUP NPI is 1235275207. The provider is registered as an organization entity type.

The provider's business location address is:

100 HIGHLAND AVE STE 307
PROVIDENCE, RI
ZIP 02906-753
Phone: (401) 331-5320
Fax: (401) 331-6168

The provider's authorized official is Marvin Stuart Kerzner .
The authorized official title is Medical Director and has the following contact phone number (401) 331-5320.

The enumeration date for this NPI number is 1/29/2007 and was last updated on 8/22/2020.

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	261QP2300X	Clinic/Center	Primary Care	RI3593	RHODE ISLAND	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	2059883	OTHER	RHODE ISLAND	AETNA
2	9000847	MEDICAID	RHODE ISLAND
3	847-1	OTHER	RHODE ISLAND	BLUE CROSS

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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