Provider Demographics
NPI:1891743332
Name:SUMMA PHYSICIAN INC
Entity Type:Organization
Organization Name:SUMMA PHYSICIAN INC
Other - Org Name:SUMMA HEALTH MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR IT SYSTEMS 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:234-312-5691
Mailing Address - Fax:
Practice Address - Street 1:623 E MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1620
Practice Address - Country:US
Practice Address - Phone:330-375-6363
Practice Address - Fax:330-379-5144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2414140Medicaid
OH2414140Medicaid