Provider Demographics
NPI:1295148260
Name:BANZHAF, SUMMER LEA (DO)
Entity type:Individual
Prefix:DR
First Name:SUMMER
Middle Name:LEA
Last Name:BANZHAF
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:416 COLEGATE DR BLDG 3
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-9549
Mailing Address - Country:US
Mailing Address - Phone:740-374-3526
Mailing Address - Fax:740-374-3165
Practice Address - Street 1:206 COLUMBUS RD STE 203
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-1316
Practice Address - Country:US
Practice Address - Phone:740-331-6910
Practice Address - Fax:740-331-6919
Is Sole Proprietor?:No
Enumeration Date:2014-06-08
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.013015207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program