Provider Demographics
NPI:1649467119
Name:MIDWEST PSYCHIATRIC CENTER, INC.
Entity type:Organization
Organization Name:MIDWEST PSYCHIATRIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAKESHKUMAR
Authorized Official - Middle Name:M
Authorized Official - Last Name:KANERIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-217-5221
Mailing Address - Street 1:PO BOX 635924
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5924
Mailing Address - Country:US
Mailing Address - Phone:513-421-3504
Mailing Address - Fax:513-231-7055
Practice Address - Street 1:7760 WEST VOA PARK DR
Practice Address - Street 2:SUITE G
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-3371
Practice Address - Country:US
Practice Address - Phone:513-217-5221
Practice Address - Fax:513-217-6221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350834402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2804013Medicaid
OH293747OtherAMERIGROUP
OH603986997-002OtherMMOH
OH=========OtherCARESOURCE
OH603986997-00OtherBWC
OH293747OtherAMERIGROUP