Organization
SUMMIT MEDICAL SPECIALISTS, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM LEVENHAGEN MD (OWNER)
(262) 513-0700
Entity
Organization
Contact information
Practice address
2717 N GRANDVIEW BLVD STE 202, WAUKESHA, WI 53188-1660
(262) 513-0700
(262) 513-0707
Mailing address
2717 N GRANDVIEW BLVD STE 202, WAUKESHA, WI 53188-1660
(262) 513-0700
(262) 513-0707
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
33398
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32189000
—
WI
Enumeration date
04/20/2007
Last updated
08/22/2020
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