Provider Demographics
NPI:1801825013
Name:MIDMICHIGAN PULMONARY, ASSOC.;P.C.
Entity Type:Organization
Organization Name:MIDMICHIGAN PULMONARY, ASSOC.;P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SUMMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-893-7460
Mailing Address - Street 1:640 S TRUMBULL ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708
Mailing Address - Country:US
Mailing Address - Phone:989-893-7460
Mailing Address - Fax:989-895-5813
Practice Address - Street 1:640 S TRUMBULL ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708
Practice Address - Country:US
Practice Address - Phone:989-893-7460
Practice Address - Fax:989-895-5813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301063905207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2900901371OtherBLUE CROSS BLUE SHIELD
MI1004181OtherCOMMUNITY CHOICE MEDICAID
MA2900901371OtherBLUE CARE NETWORK
MI2900901371OtherHEALTH PLUS
MI1004181OtherCOMMUNITY CHOICE MEDICAID
MIC41065Medicare UPIN