Individual
CHARLES RUSSELL ZACHEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
4110 WARRENSVILLE CENTER RD, BEACHWOOD, OH 44122-7024
(216) 491-6000
Mailing address
4700 ROCKSIDE RD, SUITE 200, INDEPENDENCE, OH 44131-2155
(216) 643-3114
(216) 643-3011
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
34001402Z
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
56031
—
OH
Enumeration date
03/02/2007
Last updated
07/09/2007
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