Provider Demographics
NPI:1700054061
Name:SUMMIT SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:SUMMIT SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SAYRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-376-7207
Mailing Address - Street 1:75 ARCH ST STE 404B
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1433
Mailing Address - Country:US
Mailing Address - Phone:330-376-7207
Mailing Address - Fax:
Practice Address - Street 1:75 ARCH ST STE 404B
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1433
Practice Address - Country:US
Practice Address - Phone:330-376-7207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH45457208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0980854Medicaid
OH0980854Medicaid
OHA80842Medicare UPIN