Basic Information
Provider Information
NPI: 1558591420
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KARIMOV
FirstName: ARTUR
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 30 E APPLE ST
Address2: STE NW 3300
City: DAYTON
State: OH
PostalCode: 454092939
CountryCode: US
TelephoneNumber: 9372088394
FaxNumber: 9372088388
Practice Location
Address1: 30 E APPLE ST
Address2: STE NW 3300
City: DAYTON
State: OH
PostalCode: 454092939
CountryCode: US
TelephoneNumber: 9372088394
FaxNumber: 9372088388
Other Information
ProviderEnumerationDate: 07/24/2009
LastUpdateDate: 12/19/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X35.098825OHY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
006343605OH MEDICAID


Home