Basic Information
| Provider Information | |||||||||
| NPI: | 1124356670 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUMMA PHYSICIANS INC. | ||||||||
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| OtherOrganizationName: | SUMMA HEALTH MEDICAL GROUP | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1077 GORGE BLVD | ||||||||
| Address2: | |||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443102408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2343125961 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3825 FISHCREEK RD | ||||||||
| Address2: | STE 200 | ||||||||
| City: | STOW | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2348676970 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2009 | ||||||||
| LastUpdateDate: | 03/22/2021 | ||||||||
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| AuthorizedOfficialLastName: | ROOD | ||||||||
| AuthorizedOfficialFirstName: | GINA | ||||||||
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| AuthorizedOfficialTitleorPosition: | SR DATABASE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 2343125961 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VF0040X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Female Pelvic Medicine and Reconstructive Surgery | 2084N0400X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 363A00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363L00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 364S00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | 207RE0101X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.