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Individual

MARK A SUMMERLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RD

Contact information

Practice address
4701 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-1219
(505) 727-7022
Mailing address
1150 MONTE VISTA DR, BOSQUE FARMS, NM 87068-9238
(505) 480-5752

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD2023090
NM

Other

Enumeration date
05/10/2023
Last updated
05/10/2023
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