Healthcare Provider Details

I. General information

NPI: 1851582886
Provider Name (Legal Business Name): MICHAEL HERMAN ANIKEEV M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 11/23/2020
Certification Date: 11/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12395 MCCRACKEN RD
GARFIELD HEIGHTS OH
44125-2967
US

IV. Provider business mailing address

7135 SNOWBERRY LN
CANAL WINCHESTER OH
43110-9111
US

V. Phone/Fax

Practice location:
  • Phone: 216-587-6727
  • Fax:
Mailing address:
  • Phone: 612-225-5512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35.091515
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberAG3361893-B410
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: