Individual
DR. BRYAN DEWITT CALDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
4415 EUCLID AVE STE 110, CLEVELAND, OH 44103-3759
(216) 231-5612
(216) 721-5534
Mailing address
4415 EUCLID AVE STE 110, CLEVELAND, OH 44103-3759
(216) 231-5612
(216) 721-5534
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36 002681
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0982227
—
OH
01
—
1563848
MEDICAID GROUP
OH
01
—
480031311
RR MEDICARE
OH
01
—
CH5179
RR MEDICARE GROUP
OH
Enumeration date
06/22/2005
Last updated
02/20/2008
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