Summit Medical Group | |
100 Highland Ave Ste 307 Providence RI 02906-2753 | |
(401) 331-5320 | |
(401) 331-6168 |
Full Name | Summit Medical Group |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 100 Highland Ave Ste 307, Providence, Rhode Island |
Authorized Official Name and Position | Marvin Stuart Kerzner (MEDICAL DIRECTOR) |
Authorized Official Contact | 4013315320 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Summit Medical Group 100 Highland Ave Ste 307 Providence RI 02906-2753 Ph: (401) 331-5320 | Summit Medical Group 100 Highland Ave Ste 307 Providence RI 02906-2753 Ph: (401) 331-5320 |
NPI Number | 1235275207 |
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Provider Enumeration Date | 01/29/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235275207 | NPI | - | NPPES |
847-1 | Other | RI | BLUE CROSS |
9000847 | Medicaid | RI | |
2059883 | Other | RI | AETNA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | RI3593 (Rhode Island) | Primary |
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