Provider Demographics
NPI:1003371915
Name:SUMMA PHYSICIANS INC
Entity Type:Organization
Organization Name:SUMMA PHYSICIANS INC
Other - Org Name:SUMMA HEALTH MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER, PAYER ENROLLMENT
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:234-312-5691
Mailing Address - Street 1:1077 GORGE BLVD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44310-2408
Mailing Address - Country:US
Mailing Address - Phone:234-312-5691
Mailing Address - Fax:
Practice Address - Street 1:95 ARCH ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1437
Practice Address - Country:US
Practice Address - Phone:330-375-3039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-05
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0340734Medicaid