1215127782 NPI number — SUMMIT INTERNAL MEDICINE AND PEDIATRICS, P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215127782 NPI number — SUMMIT INTERNAL MEDICINE AND PEDIATRICS, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUMMIT INTERNAL MEDICINE AND PEDIATRICS, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215127782
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/30/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10099 RIDGEGATE PKWY
Provider Second Line Business Mailing Address:
SUITE 280
Provider Business Mailing Address City Name:
LONE TREE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80124-5531
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-792-5200
Provider Business Mailing Address Fax Number:
303-792-5201

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10099 RIDGEGATE PKWY
Provider Second Line Business Practice Location Address:
SUITE 280
Provider Business Practice Location Address City Name:
LONE TREE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80124-5531
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-792-5200
Provider Business Practice Location Address Fax Number:
303-792-5201
Provider Enumeration Date:
07/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
YUEH
Authorized Official First Name:
RHODA
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PHYSICIAN/OWNER
Authorized Official Telephone Number:
303-792-5200

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  41868 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1467427971 . This is a "INDIVIDUAL NPI" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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