Provider Demographics
NPI:1588690358
Name:SUMMERFIELD, MICHAEL ERIC (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ERIC
Last Name:SUMMERFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5711 SARVIS AVE
Mailing Address - Street 2:SUITE402
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1394
Mailing Address - Country:US
Mailing Address - Phone:301-277-4844
Mailing Address - Fax:301-927-3221
Practice Address - Street 1:5711 SARVIS AVE
Practice Address - Street 2:SUITE402
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1394
Practice Address - Country:US
Practice Address - Phone:301-277-4844
Practice Address - Fax:301-927-3221
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD036125207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0106127Medicaid
DC037933400Medicaid
MD0106127Medicaid