Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 41591 | AZ |
N | 207P00000X | Emergency Physician | 5315027390 | MI |
NPI | 1013138130 |
---|---|
Provider Name | Summer D Stears-Ellis |
First Address | Tuba City, AZ 86045-0600 |
Second Address | Tuba City, AZ 86045-0600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 07/08/2009 |