Healthcare Provider Details

I. General information

NPI: 1437304284
Provider Name (Legal Business Name): NORTHERN SUMMIT RADIOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2008
Last Update Date: 11/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E MARKET ST
AKRON OH
44304-1619
US

IV. Provider business mailing address

525 E MARKET ST
AKRON OH
44304-1619
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-3043
  • Fax: 330-375-7932
Mailing address:
  • Phone: 330-375-3043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateOH

VIII. Authorized Official

Name: EDWARD A BURY JR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 330-375-3043