Provider Demographics
NPI:1992762736
Name:KYRIAKEDES, CHRIST G (DO)
Entity type:Individual
Prefix:
First Name:CHRIST
Middle Name:G
Last Name:KYRIAKEDES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WABASH AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44307
Mailing Address - Country:US
Mailing Address - Phone:330-344-6326
Mailing Address - Fax:330-253-8293
Practice Address - Street 1:400 WABASH AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307
Practice Address - Country:US
Practice Address - Phone:330-344-1799
Practice Address - Fax:330-253-8293
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34004773207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000032022OtherBC BS
OH0803661Medicaid
930117529OtherRR MCR
OH4146481Medicare PIN
OH0803661Medicaid
E76739Medicare UPIN