Provider Demographics
NPI:1841240116
Name:CORFIAS, MIKE G (MD)
Entity Type:Individual
Prefix:
First Name:MIKE
Middle Name:G
Last Name:CORFIAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:7600 SOUTHERN BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-5633
Mailing Address - Country:US
Mailing Address - Phone:330-729-9910
Mailing Address - Fax:330-726-9475
Practice Address - Street 1:7600 SOUTHERN BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-5633
Practice Address - Country:US
Practice Address - Phone:330-729-9910
Practice Address - Fax:330-726-9475
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35067444C207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2122456Medicaid
OHBC5636088OtherDEA
OHBC5636088OtherDEA
OHG76968Medicare UPIN