Healthcare Provider Details
I. General information
NPI: 1801058631
Provider Name (Legal Business Name): SUMMA PHYSICIANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/02/2008
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
60 NORTH AVE
TALLMADGE OH
44278-1916
US
IV. Provider business mailing address
1077 GORGE BLVD
AKRON OH
44310-2408
US
V. Phone/Fax
- Phone: 330-630-9726
- Fax: 330-630-2194
- Phone: 234-312-5873
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | NULL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | NULL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | NULL |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083B0002X |
| Taxonomy | Obesity Medicine (Preventive Medicine) Physician |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
WENDY
CARSON
Title or Position: MANAGER, PAYER ENROLLMENT
Credential:
Phone: 234-312-5691