Individual
DR. THOMAS JAMES KEREIAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2123 AUBURN AVE, CINCINNATI, OH 45219-2906
(513) 421-5558
(513) 632-5804
Mailing address
237 WILLIAM HOWARD TAFT, PHYS DIV, 2ND FL, CBO2-3, ATTN: CREDENTIALING, CINCINNATI, OH 45219-2906
(513) 263-8571
(513) 366-4480
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
052064
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0881283
—
OH
01
—
1628596
GATEWAY HEALTH
OH
05
—
201229680
—
IN
01
—
2705777333076
CARESOURCE
OH
01
—
4229116
AETNA
OH
01
—
793768
ANTHEM
OH
01
—
P01139508
RAILROAD MEDICARE
OH
Enumeration date
06/08/2006
Last updated
08/04/2015
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