MEDICARE: JOSEPHINE MIKHAIL MD

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	207R00000X	Internal Medicine Physician	35074575M	OH

General Provider Information

NPI Number	:	1508946708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPHINE MIKHAIL MD

Provider Business Mailing Address
First Line	:	PO BOX 92101
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44191-2101
Country	:	US
Telephone Number	:	216-383-6776
Fax Number	:	216-383-6745

Provider Business Practice Location Address
First Line	:	701 N LAKE ST STE 102
Second Line	:
City	:	MADISON
State	:	OH
Zip	:	44057-3152
Country	:	US
Telephone Number	:	440-428-1106
Fax Number	:	440-428-8697

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

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	12/30/2020

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