Provider Demographics
NPI:1518936350
Name:LAH, HARRY K (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:K
Last Name:LAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KEE
Other - Middle Name:DO
Other - Last Name:LA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:25001 EMERY ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5627
Mailing Address - Country:US
Mailing Address - Phone:216-831-9786
Mailing Address - Fax:216-831-2425
Practice Address - Street 1:25001 EMERY ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-5627
Practice Address - Country:US
Practice Address - Phone:216-831-9786
Practice Address - Fax:216-831-2425
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0433032085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036059016Medicaid
OH0707346Medicaid
ILA82902Medicare UPIN
OH0707346Medicaid
IL036059016Medicaid
ILK24870Medicare ID - Type UnspecifiedLOCATION -JOLIET