Provider Demographics
NPI:1033398292
Name:SUMMERER, MIKE H (MD)
Entity Type:Individual
Prefix:
First Name:MIKE
Middle Name:H
Last Name:SUMMERER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 FOX RUN LN
Mailing Address - Street 2:
Mailing Address - City:NORTH READING
Mailing Address - State:MA
Mailing Address - Zip Code:01864-2973
Mailing Address - Country:US
Mailing Address - Phone:781-979-3342
Mailing Address - Fax:
Practice Address - Street 1:585 LEBANON STREET
Practice Address - Street 2:HALLMARK HEALTH SYSTEM
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176
Practice Address - Country:US
Practice Address - Phone:781-979-3342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA224034207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine