Healthcare Provider Details
I. General information
NPI: 1114166246
Provider Name (Legal Business Name): SUMMA PHYSICIANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/12/2009
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
155 5TH ST NE RM 102
BARBERTON OH
44203-3332
US
IV. Provider business mailing address
1077 GORGE BLVD
AKRON OH
44310-2408
US
V. Phone/Fax
- Phone: 330-319-9700
- Fax:
- Phone: 234-312-5873
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RE0101X |
| Taxonomy | Endocrinology, Diabetes & Metabolism Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WENDY
CARSON
Title or Position: MANAGER, PAYER ENROLLMENT
Credential:
Phone: 234-312-5691