Healthcare Provider Details

I. General information

NPI: 1891894291
Provider Name (Legal Business Name): SUMMIT GASTROENTEROLOGY ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 08/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3939 S CLEVELAND MASSILLON RD
NORTON OH
44203-5611
US

IV. Provider business mailing address

3939 S CLEVELAND MASSILLON RD
NORTON OH
44203-5611
US

V. Phone/Fax

Practice location:
  • Phone: 330-753-6643
  • Fax: 330-753-3465
Mailing address:
  • Phone: 330-753-6643
  • Fax: 330-753-3465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: JESSICA SCHAEFER
Title or Position: CREDENTIALING
Credential:
Phone: 330-753-6643