National Provider Identifier

Miles Dustin Sumner, PA-C

Miles Dustin Sumner, PA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in Depew, NY and a listed phone number of (716) 668-7051.

NPI 1881939106Depew, NYPhysician Assistant

Profile Overview

NPI
1881939106
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
November 28, 2012
Last Updated
December 06, 2016

Practice Location

  • 3332 Walden Ave Ste 110
  • Depew, NY 14043-2400

Phone: (716) 668-7051

Mailing Address

  • 3761 Colin Ct
  • North Tonawanda, NY 14120-3601

Specialties

  • Physician Assistant (363A00000X)
Full Record
NPI
1881939106
Entity Type
Individual
Last Name
Sumner
First Name
Miles
Middle Name
Dustin
Name Prefix
Mr.
Credential
PA-C
Mailing Street Address
3761 Colin Ct
Mailing City
North Tonawanda
Mailing State
NY
Mailing ZIP Code
14120-3601
Mailing Country
US
Mailing Phone
(716) 491-9426
Practice Street Address
3332 Walden Ave Ste 110
Practice City
Depew
Practice State
NY
Practice ZIP Code
14043-2400
Practice Country
US
Practice Phone
(716) 668-7051
Practice Fax
(716) 668-7069
Enumeration Date
November 28, 2012
Last Updated
December 06, 2016
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)