MEDICARE: JOEY MATTHEW KORAH M.D.

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	208000000X	Pediatrics Physician	35088236	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477667004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOEY MATTHEW KORAH M.D.

Provider Business Mailing Address
First Line	:	5800 LANDERBROOK DR STE 250
Second Line	:
City	:	MAYFIELD HTS
State	:	OH
Zip	:	44124-4047
Country	:	US
Telephone Number	:	440-544-1940
Fax Number	:	440-544-1944

Provider Business Practice Location Address
First Line	:	5800 LANDERBROOK DR STE 250
Second Line	:
City	:	MAYFIELD HTS
State	:	OH
Zip	:	44124-4047
Country	:	US
Telephone Number	:	440-544-1940
Fax Number	:	440-544-1944

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

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	02/12/2024

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