Individual
MRS. KATINA MARIE SUMMERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-1900
Mailing address
3200 E CAMELBACK RD STE 250, PHOENIX, AZ 85018-2327
(602) 933-1815
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
60607
AZ
208000000X
Pediatrics Physician
R76104
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
082762
—
AZ
Enumeration date
04/30/2017
Last updated
02/01/2021
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