Healthcare Provider Details

I. General information

NPI: 1831100304
Provider Name (Legal Business Name): CHESTER H HO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 EAST BLVD SCI 128W
CLEVELAND OH
44106-1702
US

IV. Provider business mailing address

309 KNOLLWOOD TRL
RICHMOND HEIGHTS OH
44143-1482
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number35.078739
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: