Provider Demographics
NPI:1578257614
Name:HARA, KHEMAN (MD)
Entity type:Individual
Prefix:MR
First Name:KHEMAN
Middle Name:
Last Name:HARA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 SIXTH ST. S.W., AULTMAN HOSPITAL
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44710-1702
Mailing Address - Country:US
Mailing Address - Phone:330-363-9911
Mailing Address - Fax:330-580-5513
Practice Address - Street 1:2600 SIXTH ST. S.W., AULTMAN HOSPITAL
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44710-1702
Practice Address - Country:US
Practice Address - Phone:330-363-9911
Practice Address - Fax:330-580-5513
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty