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Individual

DR. COSTAS H KEFALAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
570 WHITE POND DR, SUITE 100, AKRON, OH 44320-4205
(330) 869-0124
(330) 869-2852
Mailing address
570 WHITE POND DR, SUITE 100, AKRON, OH 44320-4205
(330) 869-0124
(330) 869-2852

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
35075208K
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000285610
BCBS
OH
01
106645
UHC
OH
05
2398605
OH
01
2901130
UHC
OH
01
341296621CK
SUMMACARE
OH
01
641296621027
CARESOURCE
OH
01
730007
BUCKEYE MEDICAID
OH
01
8466976
AETNA
OH
01
P00032896
RAILROAD MEDICARE
OH
Enumeration date
10/31/2005
Last updated
08/25/2010
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