Individual
SAMUEL M SUMMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
315 E ELM ST, SUITE 100, CALDWELL, ID 83605-4857
(208) 302-7100
(208) 302-7155
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 302-7100
(208) 302-7155
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M4192
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003955300
—
ID
Enumeration date
06/22/2006
Last updated
11/10/2016
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