1265543342 NPI number — DR. ANNE E SUMMERS MD

Table of content: DR. ANNE E SUMMERS MD (NPI 1265543342)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265543342 NPI number — DR. ANNE E SUMMERS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SUMMERS
Provider First Name:
ANNE
Provider Middle Name:
E
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1265543342
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/12/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3023 HAMAKER COURT
Provider Second Line Business Mailing Address:
#100
Provider Business Mailing Address City Name:
FAIRFAX
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22031
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-641-9161
Provider Business Mailing Address Fax Number:
703-641-0383

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3023 HAMAKER COURT
Provider Second Line Business Practice Location Address:
#100
Provider Business Practice Location Address City Name:
FAIRFAX
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-641-9161
Provider Business Practice Location Address Fax Number:
703-641-0383
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  0101038414 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 060058389 . This is a "RAIL ROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 47112 . This is a "MDIPA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 541977219 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 432670 . This is a "ANTHEM HEALTHKEEPRS PLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 47112 . This is a "OPTIMUM CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 432668 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0003 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00V371C96 . This is a "MEDICARE OF VA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4053933 . This is a "AETNA PPO MC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 47112 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 541977219 . This is a "NALC AFFORDABLE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00025882 . This is a "RAIL ROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 47112 . This is a "ALLIANCE GEHA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 541977219 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 541977219 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 737705 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 005842344 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 541977219 . This is a "WPS TRICARE" identifier . This identifiers is of the category "OTHER".




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