Provider Demographics
NPI:1457317737
Name:KIROVSKI, EMIL (MD)
Entity Type:Individual
Prefix:
First Name:EMIL
Middle Name:
Last Name:KIROVSKI
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 1:4182 TONYA TRL
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-8549
Mailing Address - Country:US
Mailing Address - Phone:513-737-9999
Mailing Address - Fax:513-887-0123
Practice Address - Street 1:4182 TONYA TRL
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-8549
Practice Address - Country:US
Practice Address - Phone:513-737-9999
Practice Address - Fax:513-887-0123
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036098976207R00000X
OH35.074249207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2668233Medicaid
IL036098976Medicaid
IL036098976Medicaid
ILG79553Medicare UPIN
OHG79553Medicare UPIN
OHH007901Medicare PIN
OH569220Medicare PIN