Provider Demographics
NPI:1831693514
Name:SUMMA HEALTH CARE, PC
Entity type:Organization
Organization Name:SUMMA HEALTH CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:PANNOZZO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-776-8686
Mailing Address - Street 1:8877 W UNION HILLS DR STE 200
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-3016
Mailing Address - Country:US
Mailing Address - Phone:623-776-8686
Mailing Address - Fax:623-776-8687
Practice Address - Street 1:8877 W UNION HILLS DR STE 240
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382
Practice Address - Country:US
Practice Address - Phone:623-217-2500
Practice Address - Fax:623-218-6553
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAIN CENTERS. NATIONWIDE, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-19
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ216885OtherMEDICARE