Healthcare Provider Details

I. General information

NPI: 1790488120
Provider Name (Legal Business Name): KARTHIYAYINI MAHENDRAKUMAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17840 BAGLEY RD
MIDDLEBURG HEIGHTS OH
44130-3401
US

IV. Provider business mailing address

1 PERKINS SQ
AKRON OH
44308-1063
US

V. Phone/Fax

Practice location:
  • Phone: 440-531-6000
  • Fax:
Mailing address:
  • Phone: 330-543-3385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number34.018495
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: