Healthcare Provider Details

I. General information

NPI: 1447494612
Provider Name (Legal Business Name): CRAIG SAUTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2009
Last Update Date: 04/28/2022
Certification Date: 04/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 CARNEGIE AVE # CA-60
CLEVELAND OH
44106-2130
US

IV. Provider business mailing address

200 EUCLID AVE APT 651
CLEVELAND OH
44114-2344
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-2195
  • Fax:
Mailing address:
  • Phone: 718-594-4867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number35.144786
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number240723
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: