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General NPI Number Information
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NPI Number | 1487229266
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Entity Type | Individual
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Provider Name | DANIELLE SUMMERS PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/24/2021
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Last Update Date | 01/06/2022
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Provider Practice Location Address
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Address Line | 5001 ROCKSIDE RD FL 1
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City | INDEPENDENCE
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State | OH
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Zip | 44131-2193
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Country | US
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Telephone | 216-986-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 6770 MAYFIELD RD STE 323
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City | MAYFIELD HEIGHTS
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State | OH
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Zip | 44124-2299
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Country | US
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Telephone | 440-312-7149
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Fax | 440-312-7142
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50.006916RX
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License Number State | OH
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