Provider Demographics
NPI:1891874210
Name:MIHOK, GERALD ALBERT (DO)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:ALBERT
Last Name:MIHOK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:143 BOARDMAN CANFIELD RD
Mailing Address - Street 2:STE 302
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4804
Mailing Address - Country:US
Mailing Address - Phone:330-726-0318
Mailing Address - Fax:330-726-1268
Practice Address - Street 1:6911 BRIDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-5102
Practice Address - Country:US
Practice Address - Phone:330-726-0318
Practice Address - Fax:330-726-1268
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-05
Last Update Date:2019-08-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH34-00-2405-M207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0480779Medicaid
OH0480779Medicaid
OHA77468Medicare UPIN