Healthcare Provider Details

I. General information

NPI: 1104801471
Provider Name (Legal Business Name): ROSANNE MARIE KHO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 05/25/2022
Certification Date: 05/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-4502
US

IV. Provider business mailing address

9500 EUCLID AVE FL 8
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-6601
  • Fax:
Mailing address:
  • Phone: 216-444-6601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number29841
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number35.127714
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: