Individual
DEDDEH MK SUMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8216 RHODERICK CIR, REYNOLDSBURG, OH 43068-3745
(614) 316-2853
Mailing address
8216 RHODERICK CIR, REYNOLDSBURG, OH 43068-3745
(614) 316-2853
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
149209
OH
164W00000X
Licensed Practical Nurse
Primary
149209
OH
Other
Enumeration date
10/31/2013
Last updated
08/06/2026
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