Individual
MICHAEL P SUMIDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
719 COOK DR, STE 109, ATHENS, TN 37303-3495
(423) 745-2344
(423) 745-2314
Mailing address
PO BOX 667, ETOWAH, TN 37331-0667
(423) 745-2344
(423) 745-2314
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD27304
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3096585
—
TN
01
—
3146634
BLUE CROSS BLUE SHIELD
TN
Enumeration date
03/22/2006
Last updated
03/01/2010
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