Healthcare Provider Details

I. General information

NPI: 1366468720
Provider Name (Legal Business Name): WILLIAM FIKTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 10/04/2021
Certification Date: 10/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17747 CHILLICOTHE RD SUITE 105
CHAGRIN FALLS OH
44023-4739
US

IV. Provider business mailing address

17747 CHILLICOTHE RD SUITE 105
CHAGRIN FALLS OH
44023-4739
US

V. Phone/Fax

Practice location:
  • Phone: 440-543-8880
  • Fax:
Mailing address:
  • Phone: 440-543-8880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35.063299
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: