Provider Demographics
NPI:1851633002
Name:SUMMERS, CAROLINE RUEDA (DO)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:RUEDA
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:MODETTE
Other - Last Name:RUEDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:781 AVENT FERRY RD STE 106
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-7776
Mailing Address - Country:US
Mailing Address - Phone:919-567-6133
Mailing Address - Fax:919-567-6134
Practice Address - Street 1:781 AVENT FERRY RD STE 106
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-7776
Practice Address - Country:US
Practice Address - Phone:919-567-6133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-01353207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology