Healthcare Provider Details

I. General information

NPI: 1841739257
Provider Name (Legal Business Name): SUMMIT NEUROENDOVASCULAR SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2017
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3867 MEDINA RD # 270
AKRON OH
44333-4525
US

IV. Provider business mailing address

3867 MEDINA RD # 270
AKRON OH
44333-4525
US

V. Phone/Fax

Practice location:
  • Phone: 330-344-2387
  • Fax: 330-344-6344
Mailing address:
  • Phone: 330-344-2387
  • Fax: 330-344-6344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State

VIII. Authorized Official

Name: FIRAS AL-ALI
Title or Position: OWNER
Credential:
Phone: 330-344-2387