| Doctor Name: | MR. DAVID SUMMERALL |
| NPI Number: | 1184098626 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP-C |
| License Number: | SP015548 |
| Business Practice Address: | 55 Park Ave Collegeville, PA - 194262629 |
| Business Phone Number: | 6104092604 |
| Business Fax Number: | |
| Mailing Address: | 55 Park Ave, COLLEGEVILLE |
| State: | PA |
| Postal Code: | 194262629 |
| Phone Number: | 6104092604 |
| Fax Number: | |
| NPI Enumeration Date: | 11/20/2015 |
| NPI Last Update Date: | 02/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | SP015548 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |