Individual
CHANAPONG KITTAYARAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9500 EUCLID AVE, J4-1, CLEVELAND, OH 44195-0001
(216) 445-6816
Mailing address
35 SEVERANCE CIR, APT 316, CLEVELAND HEIGHTS, OH 44118-1523
(216) 835-6719
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/10/2010
Last updated
11/10/2010
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