Healthcare Provider Details

I. General information

NPI: 1003056300
Provider Name (Legal Business Name): MASATO FUJIKI M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2009
Last Update Date: 06/16/2020
Certification Date: 06/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

131-1 KAMEYACHO KOJINGUCHIDORI, VANTARISE 1-E KAMIGYOKU
KYOTO KYOTO
6020854
JP

V. Phone/Fax

Practice location:
  • Phone: 216-444-8007
  • Fax: 216-444-9375
Mailing address:
  • Phone: 81752515532
  • Fax: 81752236189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35.099600
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: