Provider Demographics
NPI:1356684443
Name:SUMNER, ELIZABETH JOHNSON (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:JOHNSON
Last Name:SUMNER
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:BRADLEY
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:300 VEAZEY RD
Mailing Address - Street 2:CENTRAL REGIONAL HOSPITAL
Mailing Address - City:BUTNER
Mailing Address - State:NC
Mailing Address - Zip Code:27509
Mailing Address - Country:US
Mailing Address - Phone:919-764-2000
Mailing Address - Fax:
Practice Address - Street 1:300 VEAZEY RD
Practice Address - Street 2:CENTRAL REGIONAL HOSPITAL
Practice Address - City:BUTNER
Practice Address - State:NC
Practice Address - Zip Code:27509
Practice Address - Country:US
Practice Address - Phone:919-764-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-000622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry