MEDICARE: ABRAHAM MIKALOV MD INC

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	208D00000X	General Practice Physician

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	:	1881931418
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABRAHAM MIKALOV MD INC

Provider Business Mailing Address
First Line	:	PO BOX 9664
Second Line	:
City	:	COLUMBUS
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	:	PRESIDENT
Name	:	DR. ABRAHAM MIKALOV
Credential	:	MD
Telephone Number	:	614-367-1234

Provider Enumeration Date	:	01/16/2013
Last Update Date	:	04/01/2026

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