Summerville, John William
Summerville, John William is an individual health care provider with primary practice located at 200 Medical Park Blvd , Petersburg VA 23805. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Summerville, John William can be contacted via phone (615) 221-4400.Contact Information
Primary practice address
200 Medical Park Blvd
Petersburg VA 23805
Phone: (615) 221-4400
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 0101041829 | Virginia |
Profile Details
| NPI number | 1982604120 |
|---|---|
| LBN Legal business name | Summerville, John William |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 29th, 2005 |
| Last updated | Jun 10th, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982604120 | NPPES |
| Virginia | MEDICAID | 006603858 |
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