Provider Demographics
NPI:1891030482
Name:MARIAELAINA SUMAS, MD, LLC
Entity Type:Organization
Organization Name:MARIAELAINA SUMAS, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRSEIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIAELAINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-303-6595
Mailing Address - Street 1:15 STATE AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-4456
Mailing Address - Country:US
Mailing Address - Phone:717-254-6540
Mailing Address - Fax:717-254-6586
Practice Address - Street 1:15 STATE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-4456
Practice Address - Country:US
Practice Address - Phone:717-254-6540
Practice Address - Fax:717-254-6586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD054935L207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty