Provider Demographics
NPI:1275805491
Name:SUMMIT PHYSICIANS GROUP PLLC
Entity Type:Organization
Organization Name:SUMMIT PHYSICIANS GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GALOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:248-593-9780
Mailing Address - Street 1:8560 N SILVERY LN
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-4515
Mailing Address - Country:US
Mailing Address - Phone:313-581-3255
Mailing Address - Fax:313-581-3755
Practice Address - Street 1:8560 N SILVERY LN
Practice Address - Street 2:SUITE 202
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-4515
Practice Address - Country:US
Practice Address - Phone:313-581-3255
Practice Address - Fax:313-581-3755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RM1200XAllopathic & Osteopathic PhysiciansInternal MedicineMagnetic Resonance Imaging (MRI)Group - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty