Individual
CASEY RICHARD CHARLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18101 LORAIN AVE, CLEVELAND, OH 44111-5612
(216) 368-0575
Mailing address
10900 EUCLID AVE, CLEVELAND, OH 44106-1712
(216) 368-0575
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
50.009096RX
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/10/2023
Last updated
12/10/2024
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