Individual
MOHAMAD KALASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15644 MADISON AVE, STE 101, LAKEWOOD, OH 44107
(216) 228-6565
(216) 221-5173
Mailing address
24651 CENTER RIDGE RD, SUITE 350, WESTLAKE, OH 44145-5635
(440) 895-5056
(440) 333-2935
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35061572
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000030587
ANTHEM
—
01
—
0119204
GROUP MEDICAID
—
01
—
0657195
AETNA
—
05
—
0852402
—
OH
01
—
103016
KAISER
—
01
—
10821371
CAQH
—
01
—
110131715
RR MEDICARE INDIVIDUAL
—
01
—
1780634279
GROUP NPI
—
01
—
341783789043
CARESOURCE
—
01
—
3610861
GROUP ASC MEDICARE
—
01
—
9273172
GROUP MEDICARE
—
01
—
CA4511
GROUP RR MEDICARE
—
01
—
D368301
GROUP IND DIAGNOSTICS MED
—
01
—
F61572
SUMMACARE APEX
—
Enumeration date
03/07/2006
Last updated
07/24/2012
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