MEDICARE: SUMMA PHYSICIANS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician
2	207RP1001X	Pulmonary Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437494176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMA PHYSICIANS LLC

Provider Business Mailing Address
First Line	:	1077 GORGE BLVD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44310-2408
Country	:	US
Telephone Number	:	234-312-5873
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 PORTAGE LAKES DR STE A
Second Line	:
City	:	COVENTRY TOWNSHIP
State	:	OH
Zip	:	44319-2299
Country	:	US
Telephone Number	:	234-571-9933
Fax Number	:	330-753-1499

Authorized Official
Title or Position	:	MANAGER, PAYER ENROLLMENT
Name	:	WENDY CARSON
Credential	:
Telephone Number	:	234-312-5691

Provider Enumeration Date	:	12/06/2012
Last Update Date	:	10/09/2025

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Directions to “SUMMA PHYSICIANS LLC ” Practice Location

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