Provider Demographics
NPI:1275505661
Name:MIHALIK- POTOCZAK, KAREN M (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:M
Last Name:MIHALIK- POTOCZAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:MIHALIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:590 NORTH LEAVITT RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001
Mailing Address - Country:US
Mailing Address - Phone:440-985-3050
Mailing Address - Fax:440-985-3065
Practice Address - Street 1:590 NORTH LEAVITT RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001
Practice Address - Country:US
Practice Address - Phone:440-985-3050
Practice Address - Fax:440-985-3065
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35061156M207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHF60717Medicare UPIN