Provider Demographics
NPI:1972610442
Name:SUMMA PHYSICIANS, INC.
Entity type:Organization
Organization Name:SUMMA PHYSICIANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:T. CLIFFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVENY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-996-8603
Mailing Address - Street 1:525 E MARKET ST
Mailing Address - Street 2:SPI GROUND FLOOR
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1619
Mailing Address - Country:US
Mailing Address - Phone:330-996-8603
Mailing Address - Fax:330-996-8695
Practice Address - Street 1:95 ARCH ST
Practice Address - Street 2:SUITE 165
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1437
Practice Address - Country:US
Practice Address - Phone:330-434-0543
Practice Address - Fax:330-434-0599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2461527Medicaid
SU9284143Medicare ID - Type Unspecified