Provider Demographics
NPI:1174557615
Name:CHMIELEWSKI, RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:CHMIELEWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3609 PARK EAST DR
Mailing Address - Street 2:207
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4331
Mailing Address - Country:US
Mailing Address - Phone:216-360-0456
Mailing Address - Fax:216-360-9449
Practice Address - Street 1:2322 E 22ND ST
Practice Address - Street 2:308
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-3176
Practice Address - Country:US
Practice Address - Phone:216-363-2556
Practice Address - Fax:216-363-2768
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35044871207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0493265Medicaid
OH440001650OtherRR MEDICARE
OHCH0516815Medicare PIN