MEDICARE: ALLA MIKHLI DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	36002690	OH

General Provider Information

NPI Number	:	1376547604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLA MIKHLI DPM

Provider Business Mailing Address
First Line	:	730 SOM CENTER RD STE 350
Second Line	:
City	:	MAYFIELD VILLAGE
State	:	OH
Zip	:	44143-2362
Country	:	US
Telephone Number	:	440-995-1111
Fax Number	:

Provider Business Practice Location Address
First Line	:	730 SOM CENTER RD STE 350
Second Line	:
City	:	MAYFIELD VILLAGE
State	:	OH
Zip	:	44143-2362
Country	:	US
Telephone Number	:	440-995-1111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	05/07/2019

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Directions to “ ALLA MIKHLI DPM” Practice Location

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