Provider Demographics
NPI:1194703157
Name:KARNAVAS, DIANA G (DPM)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:G
Last Name:KARNAVAS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8601 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2347
Mailing Address - Country:US
Mailing Address - Phone:330-856-2778
Mailing Address - Fax:330-856-5436
Practice Address - Street 1:4441 MAHONING AVE NW
Practice Address - Street 2:SUITE A
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-1932
Practice Address - Country:US
Practice Address - Phone:330-847-8892
Practice Address - Fax:330-847-2006
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-00-2313213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0597822Medicaid
OH0597822Medicaid
OHKA 0571238Medicare ID - Type UnspecifiedMCR ID/CORTLAND OFFICE
OHT80743Medicare UPIN
OHKA 0571236Medicare ID - Type UnspecifiedMCR ID/CHAMPION OFFICE
OHKA 0823824Medicare ID - Type UnspecifiedMCR ID/SALEM OFFICE
OHKA 0571231Medicare ID - Type UnspecifiedMCR ID/AUSTINTOWN OFFICE
OHKA 0571239Medicare ID - Type UnspecifiedMCR ID/COLUMBIANA OFFICE
OHKA 0571237Medicare ID - Type UnspecifiedMCR ID/HOWLAND OFFICE