Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 8156918-1205 | UT |
NPI | 1023332228 |
---|---|
Provider Name | Dr. Stephen James Summers |
First Address | Salt Lake City, UT 84132-2115 |
Second Address | Salt Lake City, UT 84132-2115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2010 |
Last Update Date | 23/11/2021 |