Provider Demographics
NPI:1477667004
Name:KORAH, JOEY MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:JOEY
Middle Name:MATTHEW
Last Name:KORAH
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 1:5800 LANDERBROOK DR STE 250
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-4047
Mailing Address - Country:US
Mailing Address - Phone:440-544-1940
Mailing Address - Fax:440-544-1944
Practice Address - Street 1:5800 LANDERBROOK DR STE 250
Practice Address - Street 2:
Practice Address - City:MAYFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44124-4047
Practice Address - Country:US
Practice Address - Phone:440-544-1940
Practice Address - Fax:440-544-1944
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35088236208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2701302Medicaid
OHKO4187882Medicare PIN