Basic Information
Provider Information
NPI: 1720079700
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SUMER
FirstName: NILUFER
MiddleName: K
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 401 S BALLENGER HWY
Address2:  
City: FLINT
State: MI
PostalCode: 485323638
CountryCode: US
TelephoneNumber: 8103421000
FaxNumber: 8103421590
Practice Location
Address1: 1314 S LINDEN RD
Address2:  
City: FLINT
State: MI
PostalCode: 485323456
CountryCode: US
TelephoneNumber: 8103421700
FaxNumber: 8107204057
Other Information
ProviderEnumerationDate: 10/31/2005
LastUpdateDate: 10/16/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X4301061112MIY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
100303701MIHEALTH ADVANTAGE NETWORKOTHER
11013813701MIMETRAHEALTHOTHER
110B51053001MIBLUE CROSS BLUE SHIELDOTHER
438247705MI MEDICAID
110B56125001MIBLUE CROSS BLUE SHIELDOTHER
522348801MIAETNAOTHER
100303701MIMCLAREN HEALTH PLANOTHER
106111201MIHEALTH PLUSOTHER
C589501MIMCAREOTHER
G1468101MIHEALTH NET FEDERAL SERVOTHER
110250206001MIBLUE CROSS BLUE SHIELDOTHER
110B51053001MIBLUE CHOICE POSOTHER
110B51053001MACOMMUNITY BLUEOTHER
110B51053001MIBLUE CARE NETWORKOTHER
G1468101MIHEALTH ALLIANCE PLANOTHER


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