Provider Demographics
NPI:1134103328
Name:SUMEY, STEVEN WAYNE (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:WAYNE
Last Name:SUMEY
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 1:322 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:MN
Mailing Address - Zip Code:56031-4139
Mailing Address - Country:US
Mailing Address - Phone:507-238-4844
Mailing Address - Fax:
Practice Address - Street 1:322 S STATE ST
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:MN
Practice Address - Zip Code:56031-4139
Practice Address - Country:US
Practice Address - Phone:507-238-4844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN26312207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN5T425SUMedicaid
MN604591OtherARAZ
MNA008OtherCHAMPUS
IA1069039Medicaid
MN7094OtherAVERA
MN116241OtherUCARE
MNHP29855OtherHEALTH PARTNERS
IA17430OtherIOWA BLUE CROSS
MN236863300Medicaid
MNMH9041000383OtherPREFERRED ONE
MN01-13343OtherMEDICA
MN23316OtherSIOUX VALLEY
MN5T425SUOtherBLUE CROSS
MN5T425SUOtherBLUE CROSS
MN01-13343OtherMEDICA
D75499Medicare UPIN
MN5T425SUMedicaid
MN604591OtherARAZ
MN7094OtherAVERA