Provider Demographics
NPI:1780855965
Name:SAHAKITRUNGRUANG, CHUCHEEP (MD)
Entity type:Individual
Prefix:
First Name:CHUCHEEP
Middle Name:
Last Name:SAHAKITRUNGRUANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12805 SHAKER BLVD
Mailing Address - Street 2:APT 706
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120
Mailing Address - Country:US
Mailing Address - Phone:216-925-2545
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE DEPARTMENT OF COLORECTAL SURGERY A30
Practice Address - Street 2:THE CLEVELAND CLINIC FOUNDATION
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195
Practice Address - Country:US
Practice Address - Phone:216-444-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-17
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery