Individual
DR. ELLIOTT CHANDLER DASENBROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-8500
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D0065050
MD
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
D0065050
MD
207RP1001X
Pulmonary Disease Physician
Primary
35-094125
OH
207RP1001X
Pulmonary Disease Physician
D0065050
MD
2080P0214X
Pediatric Pulmonology Physician
35-094125
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024958210001
—
PA
05
—
1780772632
—
MI
05
—
2973626
—
OH
Enumeration date
10/10/2006
Last updated
06/28/2011
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