Provider Demographics
NPI:1770748147
Name:JITTIRAT, ARKSARAPUK (MD)
Entity type:Individual
Prefix:
First Name:ARKSARAPUK
Middle Name:
Last Name:JITTIRAT
Suffix:
Gender:F
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
Mailing Address - Street 2:SUITE MATHER 1800
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1716
Mailing Address - Country:US
Mailing Address - Phone:216-844-5685
Mailing Address - Fax:216-910-6208
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:SUITE MATHER 1800
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-5685
Practice Address - Fax:216-910-6208
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA116024207RN0300X
HIMD-17725207RN0300X
OH35.129509207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology