Individual
SHYAN MARIE SUMMERALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4511 MIMOSA TREE LN APT 1206, RALEIGH, NC 27612-7063
(220) 225-1386
Mailing address
4511 MIMOSA TREE LN APT 1206, RALEIGH, NC 27612-7063
(220) 225-1386
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
NC
Other
Enumeration date
09/15/2025
Last updated
09/15/2025
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