# SUMMIT MEDICAL GROUP PLLC

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

## Provider details

- **NPI number:** 1699088468
- **Authorized official:** ALLIE GALOVICH CPC (BILLER)
- **Authorized official phone:** (248) 390-0459

## Contact information

- **Practice address:** 8560 N SILVERY LN, SUITE 202, DEARBORN HEIGHTS, MI 48127-4515
- **Practice address phone:** (313) 581-3255
- **Practice address fax:** (313) 581-3755
- **Mailing address:** 8560 N SILVERY LN, SUITE202, DEARBORN HEIGHTS, MI 48127-4515
- **Mailing address phone:** (313) 581-3255
- **Mailing address fax:** (313) 581-3755

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204C00000X | Sports Medicine (Neuromusculoskeletal Medicine) Physician | 5101008800 | MI | — |
| 207L00000X | Anesthesiology Physician | 510010514 | MI | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 4301031988 | MI | — |
| 207Q00000X | Family Medicine Physician | 5101016943 | MI | — |
| 207X00000X | Orthopaedic Surgery Physician | 510014180 | MI | — |
| 207X00000X | Orthopaedic Surgery Physician | 5101013938 | MI | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | 4301083370 | MI | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | 4301096741 | MI | — |
| 2083A0100X | Aerospace Medicine Physician | 5101015292 | GA | — |
| 2084N0400X | Neurology Physician | 430175238 | MI | — |
| 2084N0400X | Neurology Physician | 4304373315 | MI | — |
| 2084N0600X | Clinical Neurophysiology Physician | 5101008581 | MI | — |
| 2085R0202X | Diagnostic Radiology Physician | 5101011584 | MI | — |
| 208600000X | Surgery Physician | 5101017430 | MI | — |
| 208D00000X | General Practice Physician | 4301040917 | MI | Yes |

## Other

- **Enumeration date:** 07/21/2010
- **Last updated:** 01/09/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 700E031220 | BCBS | MI |