Provider Demographics
NPI:1538192141
Name:SUMMITT, MARGARET ZAVADA (MD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ZAVADA
Last Name:SUMMITT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 372
Mailing Address - Street 2:DEPT 10
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38101-0372
Mailing Address - Country:US
Mailing Address - Phone:901-202-6120
Mailing Address - Fax:901-255-5223
Practice Address - Street 1:7800 WOLF TRAIL COVE
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1753
Practice Address - Country:US
Practice Address - Phone:901-682-9222
Practice Address - Fax:901-682-9505
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20012207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3086550Medicaid
TN4099787OtherBCBS
MS02603564Medicaid
F91713Medicare UPIN
TN3086550Medicaid