Individual
DR. DANIEL DAVID SUMROK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1894 CEDAR ST, 1301 PRIMACY PARKWAY, MC KENZIE, TN 38201-2206
(731) 352-0603
(731) 352-0185
Mailing address
1894 CEDAR ST, MC KENZIE, TN 38201-2206
(731) 352-0603
(731) 352-0185
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD0000021860
TN
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
21860
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03488833
—
MS
05
—
207113001
—
AR
05
—
3063617
—
TN
Enumeration date
10/21/2005
Last updated
03/29/2018
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