Provider Demographics
NPI:1790757375
Name:MIKHAIL, EMAD A (MD)
Entity Type:Individual
Prefix:DR
First Name:EMAD
Middle Name:A
Last Name:MIKHAIL
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 1:2760 SOM CENTER RD
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44094
Mailing Address - Country:US
Mailing Address - Phone:440-306-2358
Mailing Address - Fax:440-306-2359
Practice Address - Street 1:2760 SOM CENTER RD
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44094
Practice Address - Country:US
Practice Address - Phone:440-306-2358
Practice Address - Fax:440-306-2359
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35075570208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHC75570OtherSUMMA CARE
OH2083810OtherUNITED HEALTH CARE
OH2124534Medicaid
OHP00304928OtherRAILROAD MEDICARE
OH7813229OtherAETNA
OH8076384OtherCIGNA
OH000000389088OtherANTHEM
OH203867908 027OtherCARESOURCE
OH352308OtherWELLCARE
OH8076384OtherCIGNA
OH2124534Medicaid