Healthcare Provider Details

I. General information

NPI: 1457672826
Provider Name (Legal Business Name): ATUL CHOPRA M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2010
Last Update Date: 01/22/2021
Certification Date: 01/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE # 1500
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

11100 EUCLID AVE # 1500
CLEVELAND OH
44106-1716
US

V. Phone/Fax

Practice location:
  • Phone: 713-822-7668
  • Fax:
Mailing address:
  • Phone: 216-844-3936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License NumberQ7666
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number35.133911
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: