Provider Demographics
NPI:1376558932
Name:KARIKOMI, KEVIN B (DO)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:B
Last Name:KARIKOMI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 W SCHROCK RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-2874
Mailing Address - Country:US
Mailing Address - Phone:614-895-0400
Mailing Address - Fax:614-895-2911
Practice Address - Street 1:235 W SCHROCK RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2874
Practice Address - Country:US
Practice Address - Phone:614-895-0400
Practice Address - Fax:614-895-2911
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34002669207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0592498Medicaid
OHA82020Medicare UPIN
OH0592498Medicaid