Provider Demographics
NPI:1629274246
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:SR IT SYSTEM ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:234-312-5193
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:
Mailing Address - Fax:
Practice Address - Street 1:4211 STATE ROUTE 44 STE 110
Practice Address - Street 2:
Practice Address - City:ROOTSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44272-9698
Practice Address - Country:US
Practice Address - Phone:234-837-7536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0455104Medicaid