Organization
SUMMIT SURGICAL CONSULTANTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TIEMAN MD (OWNER)
(928) 532-5463
Entity
Organization
Contact information
Practice address
5171 CUB LAKE RD, SUITE 390, SHOW LOW, AZ 85901-7888
(928) 532-5463
(928) 532-8474
Mailing address
PO BOX 1660, LAKESIDE, AZ 85929-1660
(928) 532-5463
(928) 532-8474
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
02/01/2006
Last updated
08/22/2020
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