Provider Demographics
NPI:1376030049
Name:KARTHIKEYAN, NISHOK (MD)
Entity Type:Individual
Prefix:DR
First Name:NISHOK
Middle Name:
Last Name:KARTHIKEYAN
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 1:2668 ELM RD NE BLDG C
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44410-9393
Mailing Address - Country:US
Mailing Address - Phone:330-841-1070
Mailing Address - Fax:330-841-1079
Practice Address - Street 1:2668 ELM RD NE BLDG C
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:OH
Practice Address - Zip Code:44410-9393
Practice Address - Country:US
Practice Address - Phone:330-841-1070
Practice Address - Fax:330-841-1079
Is Sole Proprietor?:No
Enumeration Date:2018-04-18
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-141897207R00000X
OH35.141897207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine