Healthcare Provider Details

I. General information

NPI: 1518549369
Provider Name (Legal Business Name): CHARLES MACKENZIE DOOLITTLE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0002
US

IV. Provider business mailing address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 330-541-1505
  • Fax:
Mailing address:
  • Phone: 513-558-2968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number34.018024
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: