Individual
DR. GREGG SUMMERVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
703 MAIN ST, PATERSON, NJ 07503-2621
(973) 754-2240
Mailing address
31 PHEASANT RUN, KINNELON, NJ 07405-3022
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA05719500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7187904
—
NJ
Enumeration date
07/29/2005
Last updated
10/01/2008
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