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General NPI Number Information
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NPI Number | 1356502074
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Entity Type | Individual
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Provider Name | CHRIST-ROI CHERES M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/25/2008
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Last Update Date | 05/30/2018
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Provider Practice Location Address
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Address Line | 13207 RAVENNA RD
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City | CHARDON
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State | OH
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Zip | 44024-7032
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Country | US
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Telephone | 440-286-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 850 HOLBORN RD
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City | STREETSBORO
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State | OH
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Zip | 44241-4307
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Country | US
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Telephone | 718-864-3527
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 35096663
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35096663
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License Number State | OH
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