Provider Demographics
NPI:1023332228
Name:SUMMERS, STEPHEN JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JAMES
Last Name:SUMMERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:30 N 1900 E
Mailing Address - Street 2:RM 3B420
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-2115
Mailing Address - Country:US
Mailing Address - Phone:801-213-2700
Mailing Address - Fax:801-585-2891
Practice Address - Street 1:30 N 1900 E
Practice Address - Street 2:RM 3B420
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-2115
Practice Address - Country:US
Practice Address - Phone:801-213-2700
Practice Address - Fax:801-585-2891
Is Sole Proprietor?:No
Enumeration Date:2010-03-17
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT8156918-1205208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology