| Summit View Primary Care | |
|
705 E State St Delmar DE 19940-1347 | |
| (302) 212-7994 | |
| (866) 635-3408 |
| Full Name | Summit View Primary Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 705 E State St, Delmar, Delaware |
| Authorized Official Name and Position | Mica Goehner (OWNER/OPERATOR) |
| Authorized Official Contact | 3022127994 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit View Primary Care 705 E State St Delmar DE 19940-1347 Ph: (302) 212-7994 | Summit View Primary Care 705 E State St Delmar DE 19940-1347 Ph: (302) 212-7994 |
| NPI Number | 1477365856 |
|---|---|
| Provider Enumeration Date | 01/23/2025 |
| Last Update Date | 01/23/2025 |
| Certification Date | 01/23/2025 |
| Medicare PECOS PAC ID | 8426575911 |
|---|---|
| Medicare Enrollment ID | O20250508000582 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477365856 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| Provider Name | Mica Rae Goehner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538744230 PECOS PAC ID: 7214326875 Enrollment ID: I20211119001590 |
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