Provider Demographics
NPI:1972973105
Name:SUMMIT URGENT CARE, P.S.
Entity Type:Organization
Organization Name:SUMMIT URGENT CARE, P.S.
Other - Org Name:SUMMIT PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANIRBAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:425-903-3141
Mailing Address - Street 1:3900 FACTORIA BLVD SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-1234
Mailing Address - Country:US
Mailing Address - Phone:425-903-3141
Mailing Address - Fax:425-903-3142
Practice Address - Street 1:3900 FACTORIA BLVD SE
Practice Address - Street 2:SUITE A
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1234
Practice Address - Country:US
Practice Address - Phone:425-903-3141
Practice Address - Fax:425-903-3142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty