Basic Information
Provider Information
NPI: 1801131545
EntityType: 2
ReplacementNPI:  
OrganizationName: SUMMA PHYSICIANS INC
LastName:  
FirstName:  
MiddleName:  
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Credential:  
OtherOrganizationName: SUMMA HEALTH MEDICAL GROUP
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 1077 GORGE BLVD
Address2:  
City: AKRON
State: OH
PostalCode: 443102408
CountryCode: US
TelephoneNumber: 2343125961
FaxNumber:  
Practice Location
Address1: 95 ARCH ST STE 130
Address2:  
City: AKRON
State: OH
PostalCode: 443041479
CountryCode: US
TelephoneNumber: 3303757055
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/06/2012
LastUpdateDate: 07/14/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ROOD
AuthorizedOfficialFirstName: GINA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: SR SYSTEMS ANALYST
AuthorizedOfficialTelephone: 2343125193
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 07/14/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


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