Active NPI
Blair Stowe Sumrall, M.D.
- Internal Medicine Physician
- Charleston, SC
National Provider Identifier
1083701080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 27033
- Practice address
- 2125 Saint Lukes Dr
Charleston, SC 29412-2038 - Phone
- (843) 817-3103
- NPI assigned
- Oct 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 27033 | SC | Primary |
Addresses
Primary practice location
2125 Saint Lukes Dr
Charleston, SC 29412-2038
Mailing address
2125 Saint Lukes Dr
Charleston, SC 29412-2038
Phone (843) 817-3103
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27033 | SC | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252540800000",
"number": "1083701080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2125 SAINT LUKES DR",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294122038",
"telephone_number": "843-817-3103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2125 SAINT LUKES DR",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294122038",
"telephone_number": "843-817-3103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUMRALL",
"first_name": "BLAIR",
"middle_name": "STOWE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2009-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "SC",
"license": "27033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.