Healthcare Provider Details

I. General information

NPI: 1356699631
Provider Name (Legal Business Name): PRANIT N. CHOTAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2012
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE OFFICE: LAKESIDE 7062
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

11100 EUCLID AVE OFFICE: LAKESIDE 7062
CLEVELAND OH
44106-1716
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-8909
  • Fax:
Mailing address:
  • Phone: 216-844-8909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4301100822
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number57.251737
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number35.145293
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: