Healthcare Provider Details

I. General information

NPI: 1316622962
Provider Name (Legal Business Name): MICHELLE CHRISTINE CHESELKA P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29111 CEDAR RD
MAYFIELD HEIGHTS OH
44124-4005
US

IV. Provider business mailing address

2000 AUBURN DR. STE. 350
BEACHWOOD OH
44122-4327
US

V. Phone/Fax

Practice location:
  • Phone: 440-646-1600
  • Fax: 440-646-1505
Mailing address:
  • Phone: 440-646-1600
  • Fax: 440-646-1505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.008360RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: