Healthcare Provider Details

I. General information

NPI: 1467421412
Provider Name (Legal Business Name): MIKHAIL S KOREN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MICHAEL S KOREN M.D.

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1653 MERRIMAN RD STE 201D
AKRON OH
44313-5279
US

IV. Provider business mailing address

2152 STOCKBRIDGE RD
AKRON OH
44313-4543
US

V. Phone/Fax

Practice location:
  • Phone: 330-552-8862
  • Fax: 330-625-5167
Mailing address:
  • Phone: 330-552-8862
  • Fax: 330-625-5167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number35.132807
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: