# SUMMIT OF DETROIT, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558497008
- **Authorized official:** ANISE L BURRELL (ADMINISTRATOR)
- **Authorized official phone:** (313) 272-8450

## Contact information

- **Practice address:** 15801 W MCNICHOLS, DETROIT, MI 48235-3543
- **Practice address phone:** (313) 272-8450
- **Practice address fax:** (313) 272-8455
- **Mailing address:** 15801 W MCNICHOLS, DETROIT, MI 48235-3543
- **Mailing address phone:** (313) 272-8450
- **Mailing address fax:** (313) 272-8455

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | 6801072558 | MI | — |
| 133V00000X | Registered Dietitian | 861501 | MI | — |
| 163W00000X | Registered Nurse | 4704191117 | MI | — |
| 207V00000X | Obstetrics & Gynecology Physician | 4301028327 | MI | — |
| 207V00000X | Obstetrics & Gynecology Physician | 4301030345 | MI | Yes |

## Other

- **Enumeration date:** 02/26/2007
- **Last updated:** 01/03/2012