Provider Demographics
NPI:1447427661
Name:CHARLES, RONALD ANDRE (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:ANDRE
Last Name:CHARLES
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 1:11100 EUCLID AVE RM 7500
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1716
Mailing Address - Country:US
Mailing Address - Phone:216-844-2432
Mailing Address - Fax:216-844-5957
Practice Address - Street 1:11100 EUCLID AVE RM 7500
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-2432
Practice Address - Fax:216-844-5957
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA302342208C00000X
OH35.125272208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery