Provider Demographics
NPI:1053331124
Name:STROHL, KINGMAN P (MD)
Entity Type:Individual
Prefix:
First Name:KINGMAN
Middle Name:P
Last Name:STROHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0445858207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0640226OtherAETNA
OH000000224334OtherUNISON
OH364058OtherWELLCARE
OH0480608Medicaid
OH745500OtherBUCKEYE
OH000000539620OtherANTHEM
OH700006845OtherRAILROAD MEDICARE
OHP00478435Medicare PIN
OH745500OtherBUCKEYE
OH364058OtherWELLCARE
OH000000224334OtherUNISON