Individual
AMITABH N CHAK
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
207RG0100X
Gastroenterology Physician
Primary
35-061996
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224253
UNISON
—
01
—
000000539538
ANTHEM
—
01
—
0643889
AETNA
OH
05
—
0848408
—
OH
01
—
100006467
RAILROAD MEDICARE
OH
01
—
363405
WELLCARE
—
01
—
741785
BUCKEYE
—
01
—
P00445621
RAILROAD MEDICARE
OH
Enumeration date
07/13/2006
Last updated
01/12/2021
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