Provider Demographics
NPI:1538146451
Name:SUMMERS, DAVID MERRILL (DO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MERRILL
Last Name:SUMMERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 THOMAS JOHNSON DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4379
Mailing Address - Country:US
Mailing Address - Phone:301-682-3370
Mailing Address - Fax:301-682-3377
Practice Address - Street 1:97 THOMAS JOHNSON DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4379
Practice Address - Country:US
Practice Address - Phone:301-682-3370
Practice Address - Fax:301-682-3377
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0039804207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
3001500OtherAETNA HMO
G4370001OtherBCBS DC
4126583OtherAETNA NON HMO
42222OtherMAMSI
0F53FROtherBCBS MD
3001500OtherAETNA HMO
C33086Medicare UPIN