Provider Demographics
NPI:1013142348
Name:KARACHALIOS, MICHAEL DIMITRIOS (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DIMITRIOS
Last Name:KARACHALIOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MEHIEL
Other - Middle Name:
Other - Last Name:KARACHALIOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:62 BORGLUM RD
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-2123
Mailing Address - Country:US
Mailing Address - Phone:516-263-9379
Mailing Address - Fax:
Practice Address - Street 1:300 COMMUNITY DR
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3816
Practice Address - Country:US
Practice Address - Phone:888-321-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-15
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-142132085R0202X
NY2736232085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology