Individual
SUMMER LYNN DAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
623 S MAIN ST STE 1, MOSCOW, ID 83843-2983
(208) 882-2011
(208) 883-1853
Mailing address
623 S MAIN ST STE 1, MOSCOW, ID 83843-2983
(208) 882-2011
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M-13745
ID
208000000X
Pediatrics Physician
MD60572758
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457627937
—
WA
01
—
P01733878
RR MEDICARE WVH
WA
Enumeration date
03/28/2012
Last updated
07/19/2024
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