Provider Demographics
NPI:1629195979
Name:SUMMIT MEDICAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:SUMMIT MEDICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MERRIAM
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:MCLENDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-607-0042
Mailing Address - Street 1:1874 PIEDMONT AVE NE
Mailing Address - Street 2:SUITE 500E
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-4869
Mailing Address - Country:US
Mailing Address - Phone:404-607-0042
Mailing Address - Fax:404-607-7086
Practice Address - Street 1:1874 PIEDMONT AVE NE
Practice Address - Street 2:SUITE 500E
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-4869
Practice Address - Country:US
Practice Address - Phone:404-607-0042
Practice Address - Fax:404-607-7086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060141261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical