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Individual

PADMAJA DUDDELLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
822 KUMHO DR, SUITE 202, FAIRLAWN, OH 44333-9297
(330) 576-0500
(330) 576-0467
Mailing address
7574 HERRICK PARK DR, HUDSON, OH 44236-2375
(330) 294-0294

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35077580
OH
208M00000X
Hospitalist Physician
35077580
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2216864
OH
Enumeration date
07/03/2006
Last updated
06/30/2009
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