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General NPI Number Information
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NPI Number | 1316755184
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR DIABETES ENDOCRINOLOGY ADIPOSITY & LONGEVITY
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Dates
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Enumeration Date | 12/24/2024
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 1653 MERRIMAN RD STE 201D
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City | AKRON
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State | OH
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Zip | 44313-5279
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Country | US
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Telephone | 330-552-8862
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Fax | 330-625-5167
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Provider Business Mailing Address
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Address Line | 1653 MERRIMAN RD STE 201D
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City | AKRON
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State | OH
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Zip | 44313-5279
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Country | US
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Telephone | 330-552-8862
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Fax | 330-625-5167
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Authorized Official
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Title or Position | PHYSICIAN-FOUNDER
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Name | DR. MIKHAIL KOREN
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Credential | MD
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Telephone | 330-552-8862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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