MEDICARE: DR. CORATTUR NATESA NATESAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RA0401X	Addiction Medicine (Internal Medicine) Physician	35083481	OH
2	207R00000X	Internal Medicine Physician	35083481N	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790770568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CORATTUR NATESA NATESAN MD

Provider Business Mailing Address
First Line	:	464 RICHMOND RD STE 102
Second Line	:
City	:	RICHMOND HEIGHTS
State	:	OH
Zip	:	44143-2704
Country	:	US
Telephone Number	:	216-486-3233
Fax Number	:	216-486-3180

Provider Business Practice Location Address
First Line	:	11201 SHAKER BLVD
Second Line	:	SUITE 240
City	:	CLEVELAND
State	:	OH
Zip	:	44104-3873
Country	:	US
Telephone Number	:	216-791-0017
Fax Number	:	216-791-0021

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	03/17/2018

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