Provider Demographics
NPI:1457037111
Name:SUMMERS, BLAKE L (MS GC)
Entity Type:Individual
Prefix:
First Name:BLAKE
Middle Name:L
Last Name:SUMMERS
Suffix:
Gender:M
Credentials:MS GC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3535 BROADWAY BLVD APT 214
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111
Mailing Address - Country:US
Mailing Address - Phone:913-588-0592
Mailing Address - Fax:913-574-1274
Practice Address - Street 1:2330 SHAWNEE MISSION PKWY STE 317
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:KS
Practice Address - Zip Code:66205-2005
Practice Address - Country:US
Practice Address - Phone:913-588-0592
Practice Address - Fax:913-574-1274
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS