Healthcare Provider Details

I. General information

NPI: 1295725901
Provider Name (Legal Business Name): WAI C. CHEUNG-O'CARROLL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 EAST BLVD
CLEVELAND OH
44106-1702
US

IV. Provider business mailing address

10701 EAST BLVD
CLEVELAND OH
44106-1702
US

V. Phone/Fax

Practice location:
  • Phone: 216-791-3800
  • Fax:
Mailing address:
  • Phone: 216-791-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036106747
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: