Healthcare Provider Details

I. General information

NPI: 1932373826
Provider Name (Legal Business Name): NEAL FRUET CHAISSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2008
Last Update Date: 04/06/2022
Certification Date: 04/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE A9-125
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE A9-125
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-7943
  • Fax: 216-445-6024
Mailing address:
  • Phone: 216-444-7943
  • Fax: 216-445-6024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number35.121950
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35.121950
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: