| Summit Clinics Pllc | |
|
2115 County Road D E Ste C Maplewood MN 55109-5353 | |
| (651) 955-6747 | |
| Not Available |
| Full Name | Summit Clinics Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2115 County Road D E Ste C, Maplewood, Minnesota |
| Authorized Official Name and Position | Vamsi Dwaram (MANAGER) |
| Authorized Official Contact | 6519556747 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Clinics Pllc 2115 County Road D E Ste C100 Maplewood MN 55109-5354 Ph: () - | Summit Clinics Pllc 2115 County Road D E Ste C Maplewood MN 55109-5353 Ph: (651) 955-6747 |
| NPI Number | 1285290072 |
|---|---|
| Provider Enumeration Date | 05/16/2019 |
| Last Update Date | 05/16/2019 |
| Medicare PECOS PAC ID | 7618201708 |
|---|---|
| Medicare Enrollment ID | O20190624001723 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285290072 | NPI | - | NPPES |
| Provider Name | Piyush Das |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1265639140 PECOS PAC ID: 7214060763 Enrollment ID: I20100804000287 |
| Provider Name | Mukesh Kumar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992966188 PECOS PAC ID: 9133396385 Enrollment ID: I20120111000744 |
| Provider Name | Mahesh Kumar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871835900 PECOS PAC ID: 6002126588 Enrollment ID: I20151112002744 |
| Provider Name | Jessica Marion Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457914160 PECOS PAC ID: 7315274164 Enrollment ID: I20190816000773 |
| Provider Name | Marcy Beth Jensen Halvorson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922628791 PECOS PAC ID: 4385048248 Enrollment ID: I20210813003053 |
| Provider Name | Ambe Ernest Che |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013487552 PECOS PAC ID: 4082005962 Enrollment ID: I20220104000919 |
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