Summerill, Shaun Stephen

Summerill, Shaun Stephen is an individual health care provider with primary practice located at 1151 Hospital Way Bldg F, Pocatello ID 83201. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Summerill, Shaun Stephen can be contacted via phone (208) 232-1443.

Contact Information

Primary practice address
1151 Hospital Way Bldg F Pocatello ID 83201
Phone: (208) 232-1443
Fax: (208) 239-3434
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 49001 Wisconsin
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 49001 Wisconsin
Allopathic & Osteopathic Physicians / Pediatrics 208000000X M-11365 Idaho

Profile Details

NPI number 1497807044
LBN Legal business name Summerill, Shaun Stephen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2007
Last updated Sep 23rd, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497807044 NPPES
Idaho MEDICAID 808342900

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