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:
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Health care specialties

SpecialtyCodeLicense #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 7 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 1982604120 NPPES
Virginia MEDICAID 006603858

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