MEDICARE: ABRAHAM MIKALOV 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	208600000X	Surgery Physician	35057674	OH
2	208D00000X	General Practice Physician	35057674	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841351061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABRAHAM MIKALOV M.D.

Provider Business Mailing Address
First Line	:	PO BOX 9664
Second Line	:
City	:	BEXLEY
State	:	OH
Zip	:	43209-0664
Country	:	US
Telephone Number	:	614-367-1234
Fax Number	:	614-367-1233

Provider Business Practice Location Address
First Line	:	6100 E MAIN ST STE 101
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-3399
Country	:	US
Telephone Number	:	614-367-1234
Fax Number	:	614-367-1233

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

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	04/18/2025

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Directions to “ ABRAHAM MIKALOV M.D.” Practice Location

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