| Doctor Name: | SUMMER ALIA BLAIR |
| NPI Number: | 1134485329 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ANP-BC |
| License Number: | 13164 |
| Business Practice Address: | 1250 Linda St Suite 103 Rocky River, OH - 441161853 |
| Business Phone Number: | 4402503560 |
| Business Fax Number: | 2167127066 |
| Mailing Address: | 1250 Linda St, Suite 103 ROCKY RIVER |
| State: | OH |
| Postal Code: | 441161853 |
| Phone Number: | 4402503560 |
| Fax Number: | 2167127066 |
| NPI Enumeration Date: | 04/02/2012 |
| NPI Last Update Date: | 01/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 13164 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |